Late-onset neutropenia: defining limits of neutrophil count in very low birth weight infants

Vetter-Laracy, Susanne; Pr, Balliu; Ja, Salinas; Ma, Duran

doi:10.1038/jp.2013.111

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Thus, there was no significant relationship between the gender of newborns and neutropenia (p-value=0.4). Vetter-Laracy et al conducted a study on this issue and found that the percentages of male and female newborns in regard to neutropenia were 55% and 45%, respectively [11]. In general, the percentage of male newborns was higher than that of female newborns.…”

Section: Discussionmentioning

confidence: 97%

Investigating neutropenia and its outcomes in newborns admitted to the Neonatal Intensive Care Unit Center in the Southwest of Iran (Imam Khomeini Hospital, Ahvaz).

Malakian¹,

Aramesh²,

Dehdashtiyan³

et al. 2019

biomedicalresearch

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Background: Neutropenia is one of the important risk factors of infection. Neutropenia is associated with various items include mother's blood pressure and hemolytic anemia. The aim of this study was evaluation of neutropenia and its complications in Neonatal Intensive Care Unit (NICU). Materials and methods: In this analytical cross sectional study, the records of 315 neonates hospitalized in the NICU of Imam Khomeini hospital were studied for the diagnosis of neutropenia. Statistical methods of independent t-test and Chi-square were used for the measurement of the date. Analyses were performed by using SPSS version 17. Results: Nineteen of 315 cases (6%) had neutropenia. There was no significant correlation between two genders (73.7% male and 26.3% female) in neutropenic neonates. Seven patients (36.8%) were dead and 12 (63.2%) were alive (P-value=0.02). Five cases (26.3%) were infected and 14 cases (73.7%) had no infection (P-value=0.86). In 10 neutropenic cases (52.6%) high blood pressure of the mother was observed during pregnancy (P-value=0.00). Significant difference was observed between birth weight infants and neutropenia (P-value=0.01). Conclusion: Our study showed that neutropenia has a reverse relationship with gestational age and low birth weight. Neutropenia has a direct significant correlation with infant mortality and high maternal hypertension. There was no significant correlation between neutropenia with neonatal infections, Apgar score 5 and the gender of neonate.

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Section: Discussionmentioning

confidence: 97%

Investigating neutropenia and its outcomes in newborns admitted to the Neonatal Intensive Care Unit Center in the Southwest of Iran (Imam Khomeini Hospital, Ahvaz).

Malakian¹,

Aramesh²,

Dehdashtiyan³

et al. 2019

biomedicalresearch

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“…The low incidence of gram-negative infections in our cohort might explain why a lower threshold yielded similar results. Moreover, as a late-onset physiologic neutropenia frequently occurs in VLBW infants, their I/T ratio might be less accurate [ 23 ]. Consequently, using a lower positivity threshold may be appropriate in order to increase its sensitivity as a screening tool in this specific population.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants

et al. 2018

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BackgroundLate-onset sepsis in very low birth weight (VLBW) infants is a diagnostic challenge. We aimed to evaluate the diagnostic utility of the C-Reactive protein (CRP) and the complete blood count (CBC) for late-onset sepsis in VLBW infants.MethodsIn a 5-year retrospective cohort of 416 VLBW infants born at less than 1500 g, there were 590 separate late-onset sepsis evaluations. CRP and CBC were drawn at time of initial blood culture (T0), at 16–24 h (T24) and 40–48 h (T48) after. The positive cut-off values for abnormal values were the following: CRP ≥10 mg/L and CBC with at least one anomaly, including white blood cell count < 5000/mm3, immature neutrophil/total neutrophil ratio > 0.10, or platelet count < 100,000/uL. Sensitivity and specificity for predicting late-onset sepsis were calculated for each laboratory test and their combinations. Receiver operating characteristics curves were obtained for each test and for the absolute change from T0 to T24 in the laboratory value of CRP, white blood cell count and immature neutrophil/total neutrophil.ResultsAt T0, combining the CBC and the CRP had the highest sensitivity of 66% (95% confidence interval [CI], 58–73) compared to both individual tests for predicting late onset sepsis. At T24, CRP’s sensitivity was 84% (95% CI, 78–89) and was statistically higher than the CBC’s 59% (95% CI, 51–67). The combination of CBC at T0 and CRP at T24 offered the greatest sensitivity of 88% (95% CI, 82–92) and negative predictive value 93% (95% CI, 89–96), with fewer samples, compared to any other combination of tests. The area under the curve for the change in the white blood cell count from T0 to T24 was 0.82.ConclusionAt initial sepsis evaluation (T0), both CBC and CRP should be performed to increase sensitivity. A highly negative predictive value is reachable with only two tests: a CBC at T0 and a CRP a T24.

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“…Transient neutropenia of infants is typically observed at ~3-4 weeks of life in former preterm newborns who suffered from anemia of prematurity. [138][139][140] It is probably related to HSC competition between compensatory erythropoiesis and granulocytopoiesis. [138][139][140] Severe CN Severe CN syndromes can obviously have their clinical presentation in neonatal age.…”

Section: Transient Of Infantsmentioning

confidence: 99%

“…138–140 It is probably related to HSC competition between compensatory erythropoiesis and granulocytopoiesis. 138–140…”

Section: Special Situationsmentioning

confidence: 99%

The European Guidelines on Diagnosis and Management of Neutropenia in Adults and Children: A Consensus Between the European Hematology Association and the EuNet-INNOCHRON COST Action

et al. 2023

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Neutropenia, as an isolated blood cell deficiency, is a feature of a wide spectrum of acquired or congenital, benign or premalignant disorders with a predisposition to develop myelodysplastic neoplasms/acute myeloid leukemia that may arise at any age. In recent years, advances in diagnostic methodologies, particularly in the field of genomics, have revealed novel genes and mechanisms responsible for etiology and disease evolution and opened new perspectives for tailored treatment. Despite the research and diagnostic advances in the field, real world evidence, arising from international neutropenia patient registries and scientific networks, has shown that the diagnosis and management of neutropenic patients is mostly based on the physicians' experience and local practices. Therefore, experts participating in the European Network for the Innovative Diagnosis and Treatment of Chronic Neutropenias have collaborated under the auspices of the European Hematology Association to produce recommendations for the diagnosis and management of patients across the whole spectrum of chronic neutropenias. In the present article, we describe evidence-and consensus-based guidelines for the definition and classification, diagnosis, and follow-up of patients with chronic neutropenias including special entities such as pregnancy and the neonatal period. We particularly emphasize the importance of combining the clinical findings with classical and novel laboratory testing, and advanced germline and/or somatic mutational analyses, for the characterization, risk stratification, and monitoring of the entire spectrum of neutropenia patients. We believe that the wide clinical use of these practical recommendations will be particularly beneficial for patients, families, and treating physicians.

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Late-onset neutropenia: defining limits of neutrophil count in very low birth weight infants

Cited by 7 publications

References 28 publications

Investigating neutropenia and its outcomes in newborns admitted to the Neonatal Intensive Care Unit Center in the Southwest of Iran (Imam Khomeini Hospital, Ahvaz).

Investigating neutropenia and its outcomes in newborns admitted to the Neonatal Intensive Care Unit Center in the Southwest of Iran (Imam Khomeini Hospital, Ahvaz).

C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants

The European Guidelines on Diagnosis and Management of Neutropenia in Adults and Children: A Consensus Between the European Hematology Association and the EuNet-INNOCHRON COST Action

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