Valiaveedan R, Rao S, Miller S, Brown A
Department of Pediatrics, SUNY Health Science Center, Brooklyn 11203.
Clin Pediatr (Phila). 1987 Dec;26(12):639-42. doi: 10.1177/000992288702601204.
Patient characteristics and clinical course are described in 21 children with newly discovered neutropenia (absolute neutrophil count less than 1500/microliter). Only children over age 3 months are included; 19 of 21 were less than age 2 years. The majority had respiratory tract infections and 11 had been on various medications at the time neutropenia was discovered. Bacteria were isolated from the blood of three patients (S. pneumoniae in two, H. influenzae in one) and from urine in one (E. coli). Respiratory syncytial virus was cultured from the nasopharynx of two patients. Opportunistic, gram-negative and staphylococcal infections did not occur. Neutrophil counts in all but one child returned to normal within 6 weeks of onset; half recovered within 7 days. Bone marrow examination was performed in 13 patients: maturation arrest at various stages in the myeloid series was noted in six, and seven had normal myeloid maturation. Bone marrow findings did not correlate with degree or duration of neutropenia. These observations indicate that previously well infants with isolated neutropenia generally have a benign clinical course, although three patients were ultimately proven to have significant chronic illness. Recommendations are made as to management.
对21例新发现中性粒细胞减少症（绝对中性粒细胞计数低于1500/微升）患儿的患者特征及临床病程进行了描述。仅纳入3个月以上的儿童；21例中有19例年龄小于2岁。大多数患儿有呼吸道感染，11例在发现中性粒细胞减少症时正在使用各种药物。3例患者血液中分离出细菌（2例为肺炎链球菌，1例为流感嗜血杆菌），1例尿液中分离出细菌（大肠杆菌）。2例患者鼻咽部分离出呼吸道合胞病毒。未发生机会性感染、革兰氏阴性菌感染及葡萄球菌感染。除1例患儿外，所有患儿的中性粒细胞计数在发病后6周内恢复正常；半数在7天内恢复。13例患者进行了骨髓检查：6例在髓系各阶段出现成熟停滞，7例髓系成熟正常。骨髓检查结果与中性粒细胞减少症的程度及持续时间无关。这些观察结果表明，既往健康的单纯性中性粒细胞减少症婴儿通常临床病程良性，尽管最终有3例患者被证实患有严重慢性病。文中针对管理提出了建议。
