Hematological indices in pediatric patients with acyanotic congenital heart disease: a cross-sectional study of 248 patients

Abstract

Background Congenital heart disease CHD is a significant cause of mortality and morbidity in children worldwide. Patients with congenital heart disease may develop hematological problems, including thrombocytopenia and neutropenia. In addition, several studies indicate the higher frailty of patients with CHDs to infections and malignancies. Nevertheless, the mechanisms of immune system changes in these patients have remained in the shadow of uncertainty. Moreover, very few studies have worked on cytopenia in CHD. This study has assessed the frequency of thrombocytopenia, neutropenia, lymphopenia, and anemia in pediatric patients with acyanotic congenital heart disease ACHD prior to open-heart surgery. Methods This cross-sectional study was handled in the Pediatric Cardiology Clinic, Tehran University of Medical Sciences, during pre-operation visits from 2014 till 2019. Two hundred forty-eight children and adolescents with acyanotic congenital heart disease before open-heart surgery met the criteria to enter the study. Results A total of 191 (76.7%) patients with Ventricular Septal Defects (VSD), 37 (14.85%) patients with Atrial Septal Defects (ASD), and 20 (8.11%) patients with Patent Ductus Arteriosus (PDA) were enrolled in this study. The median age was 23.87 months. Thrombocytopenia and neutropenia were found, respectively, in 3 (1.2) and 23 (9.2%) patients. Hemoglobin level and lymphocyte count were significantly lower in patients with neutropenia than patients with normal neutrophil count (P value = 0.024 and P value = 0.000). Significant positive correlations were found between neutropenia and anemia. There were no correlations between neutrophil count and Platelets. Also, anemia was found in 48 patients (19.3%). The study also found a statistically significant correlation between the co-existence of VSD and neutropenia in the patients (P value = 0.000). Conclusion Although most were mildly neutropenic, there was a significant correlation between neutropenia and Ventricular Septal Defect compared to PDA and ASD groups. Regarding the importance of neutropenia to affect the prognosis of congenital heart defects in infections, it is important to consider further studies on the status of immune system function in these patients.

Anemia in Children with Congenital Heart Disease: A Finding from Low-Resource Setting Hospitals

“…Additionally, nearly half of the children had mixed CHD problems; therefore, this might exaggerate the prevalence of anemia in our finding. Relatively, our finding is equivalent or relatively similar finding with the studies by Mohammadi et al and Gaiha et al with a prevalence of 18.18% and 19.3% [ 16 , 20 ]. However, iron deficiency anemia is reported to be common in individuals with CCHD even in the presence of high hematocrit levels.…”

“…This explanation strengthen by the study conducted in India showed that hemoglobin and hematocrit levels and RBC count were paradoxically higher in the CCHD as compared to the healthy controls [ 21 ]. Regarding the ACHD cases, the prevalence of anemia in our study was equivalent to that found in studies conducted by Mohammadi et al and Gaiha et al [ 16 , 20 ].…”

“…Different types of cardiac malformation can affect blood index levels like hemoglobin, white blood cell, and neutrophil count in varying degrees [ 16 ]. Our study was conducted to evaluate the status of anemia using only hemoglobin levels.…”

Real-world data of leukopenia evaluation as seen in a community academic center

“…This is consistent with previous research, which has demonstrated a potential correlation between Ventricular Septal Defect (VSD) and neutropenia. 3 Additionally, we unraveled the well-documented association of cirrhosis and HCV infection with leukopenia, attributed to the toxic effects of HCV and alterations in the bone marrow microenvironment influencing stem cell differentiation. 4 Furthermore, our study recognized the potential significance of identifying hematological malignancy in the context of autoimmune diseases, particularly rheumatoid arthritis (RA).…”

Risk Factors of Mortality in the Intensive Care Unit Following Cardiac Surgery for Congenital Heart Diseases in Children

“…Congenital heart disease (CHD) is the most common developmental anomaly (4 -10 per 1,000 live births), representing an important noninfectious cause of death in children. Patients with CHD are at higher risk of infections (1). Many of them will undergo cardiac surgery, whose outcomes depend on many preoperative, intraoperative, and postoperative factors.…”