Neutropenia in the newborn

Maheshwari, Akhil

doi:10.1097/moh.0000000000000010

Cited by 65 publications

(45 citation statements)

References 84 publications

(74 reference statements)

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“…We used the maximum (creatinine) or minimum (platelet count, ANC) value recorded when multiple laboratory results were available on a given day. We defined neutropenia as ANC <1000 cells/μL, 11 thrombocytopenia as platelet count <100,000/μL, 12 and abnormal renal function as serum creatinine ≥1.3 mg/dL. 13 …”

Section: Methodsmentioning

confidence: 99%

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

et al. 2016

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Objective Identify the progression of specific signs of multi-organ dysfunction among infants with fatal sepsis. Study design Cohort study of 679 infants who died within 3 days of the start of a late-onset sepsis (LOS) episode in neonatal intensive care units from 1997–2012. We extracted clinical and laboratory data on the day of death (day 0) and the preceding 5 days (days −5 to −1). Results Median (25th percentile-75th percentile) gestational age was 25 (24–28) weeks. Compared with day −1, day 0 was characterized by an increased requirement for mechanical ventilation and higher mean fraction of inspired oxygen. Measures of cardiorespiratory support and the proportion of infants with neutropenia began to rise on day −2. Conclusions Hospitalized infants with fatal LOS manifest respiratory, cardiovascular, renal, immune, and hematologic dysfunction. Knowledge of these factors and their timing may be important for the development and testing of novel therapeutics to reduce sepsis mortality.

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Section: Methodsmentioning

confidence: 99%

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

et al. 2016

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“…If the neonate is severely neutropenic and there is concern about the risk of severe infections, G-CSF may be helpful in this specific setting. [37] A recently published, large, retrospective study of 348 neonatal intensive care units with 30,705 neutropenic infants, 2142 treated with G-CSF (7%), showed that G-CSF shortened the time for hematological recovery but did not reduce secondary sepsis or death at 14 days compared to untreated infants. [38] Thus the specific cause for neutropenia and other clinical factors should be considered in all cases.…”

Section: Pregnancymentioning

confidence: 99%

An update on the diagnosis and treatment of chronic idiopathic neutropenia

Dale¹,

Bolyard

2017

Current Opinion in Hematology

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Purpose of Review Neutropenia lasting for at least for 3 months and not attributable to drugs or a specific genetic, infectious, inflammatory, autoimmune or malignant cause is called chronic idiopathic neutropenia. (CIN) CIN and autoimmune neutropenia (AIN) are very similar and overlapping conditions. The clinical consequences depend upon the severity of neutropenia, but it is not considered a premalignant condition. Recent findings Long-term observational studies in children indicate that the disease often lasts for 3 to 5 years in children, then spontaneously remits, but it rarely remits in adult cases. The value of anti-neutrophil antibody testing in both children and adults is uncertain. Most recent data suggest that CIN and AIN are immune mediated diseases, but there are no new clinical or genetic tests to aid in diagnosis. Treatment with granulocyte colony stimulating factor (G-CSF) is effective to increase blood neutrophils in almost all cases; this treatment is reserved, however for patients with both neutropenia and evidence of recurrent fevers, inflammatory symptoms and infections. There is little or no evidence to indicate that G-CSF treatment predisposes to myeloid malignancies in this population. Summary It is important to recognize CIN and AIN, the most common causes of chronic neutropenia in both children and adults. If the neutropenia is not severe, i.e. > 0.5 × 109/L, most patients can be observed and not treated prophylactically with antibiotics or a growth factor. When neutropenia is severe treatment with G-CSF is often beneficial.

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“…Furthermore, ANCs < 1,000/μl is frequently seen at neonatal intensive care units, especially in preterm infants. Neutropenia in a neonate is mostly due to non-immune causes including sepsis, low birth weight, and pregnancy-induced maternal hypertension (table 2) [54,55,56]. Clinicians should consider further evaluation of neonatal neutropenia if no clear underlying cause is present and/or if the ANC does not increase within 3-5 days.…”

Section: Diagnosismentioning

confidence: 99%

Neonatal Alloimmune Neutropenia

Porcelijn

Haas

2018

Transfus Med Hemother

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Neonatal alloimmune neutropenia (NAIN, NAIN or NIN) is a neutrophil blood group antagonism, analogous to hemolytic disease of the fetus and newborn (HDFN) and fetal/neonatal alloimmune thrombocytopenia (FNAIT). A limited number of prospective screening studies showed that granulocyte-specific antibodies were detectable in 0.35-1.1% of random postnatal maternal samples and that the incidence of NAIN was below 0.1%. Symptoms vary from none to mild skin infections, omphalitis or more severe infections like pneumonia, sepsis, and meningitis. Treatment of neonatal infection with antibiotics and granulocyte-colony stimulating factor is advised.

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Neutropenia in the newborn

Cited by 65 publications

References 84 publications

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

An update on the diagnosis and treatment of chronic idiopathic neutropenia

Neonatal Alloimmune Neutropenia

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