Please cite this article as: Velthove KJ, Leufkens HGM, Souverein PC, Schweizer RC, Bracke M, van Solinge WW. Effects of glucocorticoids on the neutrophil count: a cohort study among hospitalized patients, Pulmonary Pharmacology & Therapeutics (2009), doi: 10.1016/j.pupt.2009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. with glucocorticoid use or that other factors, like disease and severity of disease, should be considered. The objective of this study was to investigate the effect of systemic glucocorticoids on the absolute neutrophil count in hospitalized patients.
M A N U S C R I P T A C C E P T E D ARTICLE IN PRESSMethods: A cohort study was conducted using data from the Utrecht Patient OrientedDatabase which comprises clinical data of patients of the University Medical Center Utrecht.We identified all adult patients, hospitalized in 2005 with at least two blood samples for hematological testing during admission and compared in hospital glucocorticoid use with nonuse.Results: A total of 809 glucocorticoid users and 2,658 non-users were included in the study with comparable neutrophil counts at admission (8.2.10 9 /l for glucocorticoid users and 8.0.10 9 /l for non-users). Overall analysis showed a slight association between glucocorticoid use and an increase in neutrophil count (RR 1.3; 95% CI 1.1-1.5). However, within diagnostic subgroups there was no increase in neutrophil count in glucocorticoid users. Furthermore, among all no dose response relationship, no effect of time between the two samples, and no effect of anti-inflammatory/sodium retaining potency was found.
Conclusion:Observed neutrophilia in users of systemic glucocorticoids is probably associated with underlying disease, rather than glucocorticoid use itself.