Retrospective evaluation of neutropenic patients

Neutrophils play an important role in host defence and acute inflammation. It is known that when the neutrophil count decreases, susceptibility to infection increases. Neutropenia is defined as an absolute neutrophil count below -2 SDS of the age-expected value, below 1000/mm³ between 2 weeks and 1 year of age, and below 1500/mm³ between 1 and 18 years of age. The most common aetiological causes include viral infections, medications, vitamin B12 and folic acid deficiency, and autoimmunity. There are few studies on the aetiology of neutropenia in children, and there is no consensus on the approach to neutropenic patients. In this study, we aimed to determine the causes of neutropenia in children aged 1-18 years who were referred to our hospital and followed up over the past 5 years, to examine their clinical and laboratory findings, and to evaluate the prognosis of the disease. In our study, a total of 874 visits by 537 patients aged 1–18 years with an absolute neutrophil count below 1500/mm³ who visited the paediatric clinics of Süleyman Demirel University Research and Application Hospital between January 2020 and November 2024 were evaluated. Patients with a diagnosis of malignancy or aplastic anaemia, those receiving chemotherapy or radiotherapy, and those who died during follow-up were excluded from the study, resulting in a final sample of 521 patients. Of the patients included in the study, 49.5% were female and 50.5% were male, with an average age of 5.26 ± 4.47 years. In our study, the majority of the sample consisted of patients under the age of 4 (54%). The most common age group for neutropenia was 1–1.9 years. Moderate neutropenia was the most common type in the overall sample. Severe neutropenia was most common in January and least common in August. Neutropenia was also more common in winter and autumn, when infectious diseases are more prevalent. The most common diagnosis group was infectious diseases at 44.5%; among these, upper respiratory tract infection, acute gastroenteritis, and lower respiratory tract infection were the most common. Elevated C-reactive protein levels were also observed in patients with severe neutropenia. In conclusion, our study found that, consistent with the literature, infectious diseases were the most common cause of neutropenia. The longer recovery times for neutropenia observed in our study compared to other studies were attributed to patients not attending regular follow-up appointments. It is important to monitor patients with neutropenia more closely and to determine the aetiology of neutropenia. The prognosis and mortality of the disease are closely related to the treatment of the underlying disease and the prevention of infections. Keywords: İnfection, hemoglobin, absolute neutrophil count, neutropenia, platelet