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儿童中性粒细胞减少症:一家三级医疗中心的5年经验

Neutropenia in childhood: a 5-year experience at a tertiary center.

作者信息

Lindqvist Henric, Carlsson Göran, Moell Jacob, Winiarski Jacek, Sundin Mikael

机构信息

Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden,

出版信息

Eur J Pediatr. 2015 Jun;174(6):801-7. doi: 10.1007/s00431-014-2465-5. Epub 2014 Dec 2.

Abstract

UNLABELLED

Clinical characteristics corroborated by laboratory investigations are essential to determine the etiology in cases of childhood neutropenia and the level of future health-care needs. Here the presentation, findings, and need of interventions in different types of neutropenia in children followed at our center from 2007 to 2012 were investigated retrospectively. Children with congenital and autoimmune neutropenia presented at a significantly younger age and with lower absolute neutrophil granulocyte counts than those with other types of neutropenia (p < 0.01-0.05). The duration of neutropenia, in case of remission, was shorter in post-infection and drug-induced cases compared to autoimmune and chronic idiopathic neutropenias (p = 0.001). Least affected from infections were children with ethnic and post-infection neutropenias compared to the others (p = 0.01-0.05). With the exception of congenital and autoimmune neutropenias, neutropenic children had few clinical infections and few hospital admissions even though the outpatient visit frequency was similar among the groups. A vast majority of the patients received no antibiotic prophylaxis.

CONCLUSION

The majority of patients with pediatric neutropenia, apart from congenital types, display a benign clinical course. Our data suggest that most neutropenic children need neither antibiotic prophylaxis nor extensive medical attention.

摘要

未标注

经实验室检查证实的临床特征对于确定儿童中性粒细胞减少症病例的病因以及未来医疗需求水平至关重要。在此,我们回顾性研究了2007年至2012年在我们中心随访的不同类型儿童中性粒细胞减少症的临床表现、检查结果及干预需求。先天性和自身免疫性中性粒细胞减少症患儿的发病年龄明显更小,绝对中性粒细胞计数低于其他类型的中性粒细胞减少症患儿(p < 0.01 - 0.05)。与自身免疫性和慢性特发性中性粒细胞减少症相比,感染后和药物性中性粒细胞减少症患儿(若病情缓解)的中性粒细胞减少持续时间更短(p = 0.001)。与其他患儿相比,种族性和感染后中性粒细胞减少症患儿受感染的影响最小(p = 0.01 - 0.05)。除先天性和自身免疫性中性粒细胞减少症外,中性粒细胞减少症患儿的临床感染较少,住院次数也较少,尽管各组的门诊就诊频率相似。绝大多数患者未接受抗生素预防治疗。

结论

除先天性类型外,大多数儿童中性粒细胞减少症患者的临床病程呈良性。我们的数据表明,大多数中性粒细胞减少症患儿既不需要抗生素预防治疗,也不需要广泛的医疗关注。

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