Clinical Profile and Short Term Outcome of Children with Neutropenia

Abstract

Objectives: To study the clinical profile and short term outcome of neutropenia in children during hospital stay.

Methods: An observational study was carried out at a Children's Hospital. The study population comprised of 77 admitted children aged 1 mo to 18 y with a varied clinical profile and neutropenia; defined as absolute neutrophil count less than 1500/mm³. Patients known to have HIV, immunodeficiency, malignancy, aplastic anemia or chronic systemic illness were not enrolled. Necessary investigations were done to identify etiology as per clinical features. They were treated and followed up for a period of 4 wk or discharge; whichever was earlier. The primary outcome of duration of neutropenia and secondary outcomes of hospital stay duration, association with thrombocytopenia, incidence of complications and finally discharge/death were analyzed.

Results: Acute transient neutropenia was seen, the median duration being 3 d in younger patients. Dengue fever was the commonest etiology. The median duration of hospital stay was 8 d. Fifty three (68.8%) patients had associated thrombocytopenia. Three children developed complications like nosocomial sepsis and shock. Seventy two (93.5%) were discharged, 1 died, 3 left against medical advice and one patient was followed up for 4 wk.

Conclusions: Acute febrile illnesses like dengue, enteric fever, malaria are the predominant causes of neutropenia. Mild neutropenia was seen in over 50% children requiring a short duration of admission (5-8 d); without any complications.

Keywords: Dengue; Febrile illness; Neutropenia; Non malignant.