Abstract
BackgroundBenign neutropenia, i.e., neutropenia not associated with an increased risk of infection, may result in serious medical consequences when a 'standard' definition of neutropenia (absolute neutrophil count (ANC) < 1.5 × 109cells/L) is universally applied to all races. The aims of this study were to determine the prevalence of benign neutropenia among healthy Arabs and evaluate its mode of inheritance.MethodsANCs were studied prospectively amongst a healthy indigenous population (n = 1032) from the United Arab Emirates undergoing a nation-wide sickle-cell and thalassemia screening program. The mean neutrophil count and the prevalence of benign neutropenia were compared by age, sex and amongst various tribes.ResultsThe mean neutrophil count (× 109cells/L) was 3.3 (range 0.95–7.6). Benign neutropenia was present in 110 (10.7%) subjects of whom 24 (2.3%) individuals had moderate neutropenia (ANC 0.5 – 1.0 × 109 cells/L). In the 22 tribe-family groups, the prevalence of benign neutropenia varied between 0% and 38%. Benign neutropenia showed no difference in the frequency amongst the sexes (p = 0.23) and it was independent of age (Spearman's rho = 0.05, p = 0.13). The age-related mean neutrophil count was the lowest in Arabs when compared with other ethnic groups (Blacks, Europeans and Mexicans). The inheritance of benign neutropenia was consistent with an autosomal dominant pattern; however, the diversity of observed phenotypes suggested the presence of more than one genetic variant for this trait.ConclusionArabs have a high prevalence of benign neutropenia that may be inherited as an autosomal dominant trait.
Highlights
Benign neutropenia, i.e., neutropenia not associated with an increased risk of infection, may result in serious medical consequences when a 'standard' definition of neutropenia (absolute neutrophil count (ANC) < 1.5 × 109cells/L) is universally applied to all races
The neutropenia that is not associated with an increased risk of infections has been called benign neutropenia (BN)
As ethnicity is known to affect neutrophil count, we compared the mean neutrophil count of the Arab subjects in this study, of mainly young adults, with those previously reported in American Blacks, Whites and Mexicans [2]
Summary
I.e., neutropenia not associated with an increased risk of infection, may result in serious medical consequences when a 'standard' definition of neutropenia (absolute neutrophil count (ANC) < 1.5 × 109cells/L) is universally applied to all races. The aims of this study were to determine the prevalence of benign neutropenia among healthy Arabs and evaluate its mode of inheritance. The neutropenia that is not associated with an increased risk of infections has been called benign neutropenia (BN). Using this description, BN has been reported in up to 30% of people of African origin [1]. Acquired chronic idiopathic neutropenia, which uses a higher cutoff for the neutrophil count and is related to inflammation, should be distinguished from ethnic BN [3,4]
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