Table of ContentsView AllTable of ContentsTypesCauses of Pediatric NeutropeniaPediatric Neutropenia SymptomsDiagnosisPediatric Neutropenia TreatmentPrognosisFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types
Causes of Pediatric Neutropenia
Pediatric Neutropenia Symptoms
Diagnosis
Pediatric Neutropenia Treatment
Prognosis
Frequently Asked Questions
Pediatricneutropeniais an uncommon condition that causes a low count of white blood cells called neutrophils in babies and children. This type of cell help prevent infection. There are several potential causes, including viruses, an autoimmune condition, cancer treatment, and others.
Neutropenia is more common in infancy and early childhood with rates dropping as a child grows.
This article discusses the types of pediatric neutropenia and what causes them. It also reviews symptoms, the diagnostic process, treatment options, and the prognosis for children with this condition.
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Types of Pediatric Neutropenia
The type of neutropenia affecting a child factors into how long it may last, how it can be treated, and more. Pediatric neutropenia types include acute, cyclic, congenital, autoimmune, and chronic idiopathic neutropenia.
Acute Neutropenia
A viral infection is the most common reason for pediatric neutropenia. The body uses up white blood cells to fight the infection, temporarily lowering a child’s count.
White blood cell levels should return to normal once the child recovers. This usually takes six weeks or less.
Cyclic Neutropenia
With this type, low neutrophil counts are only present for three to six days every three weeks (on average).
Cyclic neutropenia can affect children and adults, and more than one person in a family is likely to have it. In children, the condition usually begins to improve after puberty.
Congenital Neutropenia
This type of neutropenia is inherited and tends to be the most severe. It is the most common type in children younger than 4 and is usually diagnosed when the child develops a life-threatening bacterial or fungal infection.
Autoimmune Neutropenia (Chronic Benign Neutropenia of Childhood)
With autoimmune neutropenia (AIN), bone marrow makes neutrophils as it should, but the body incorrectly makes antibodies to neutrophils that mark them for destruction.
Autoimmune neutropenia is often diagnosed around 7 to 9 months of age. Fortunately, it disappears on its own in most children within two years.
Autoimmune neutropenia that occurs in combination with immune thrombocytopenia (ITP) or autoimmune hemolytic anemia (AIHA) is calledEvans Syndrome.
Chronic Idiopathic Neutropenia
This type is referred to as idiopathic because there is no known cause.
Cyclic Neutropenia Symptoms, Diagnosis, and Treatment
Pediatric neutropenia can have a number of causes. These can include:
And with the idiopathic type, the cause is unknown.
Pediatric autoimmune neutropenia typically presents in infants 6 to 15 months of age, but can occur at any age.
Rates of neutropenia vary based on a child’s ethnicity and where they live in the world.
In the United States, the rate of neutropenia is 7.2% for children under 2 years old and 3.7% for those ages 3 to 5. It drops to 2.3% for 6- to 8-year-olds.
Globally, the condition is most prevalent among children in North African and Arab nations, affecting about 15.4% of children under 6 years of age.
Overview of Neutropenia During Chemotherapy
Despite the exceptionally low neutrophil count that defines pediatric neutropenia, serious infections are rare. As a result, the condition may not cause profound symptoms. Most children have no symptoms at all.
However, you may notice that your child:
In these cases, neutropenia may be discovered when acomplete blood count (CBC)is done to diagnose an infection.
When to Have Your Sick Child Evaluted
A CBC is the first diagnostic test that will be done. This is a blood test that reports on several blood components.
With pediatric neutropenia, theabsolute neutrophil count (ANC)is typically below 1000 cells per microliter and can be below 500. Usually, thehemoglobinandplatelet count are normal.
Aperipheral blood smearmay also be done. This is an examination of the blood cells under a microscope. Although the number of neutrophils is low, they usually look normal.
Next, a healthcare provider will likely obtain CBCs twice weekly for at least six weeks. This is done to ensure that your child does not havecyclic neutropenia.
Additional Testing
Your physician may order additional testing to determine if there are antibodies to the neutrophils. A positive result confirms autoimmune neutropenia. Unfortunately, a negative result doesn’t rule it out.
In some patients, anti-neutrophil antibodies are never identified. In these cases, if the age and presentation fit the picture of autoimmune neutropenia, the diagnosis is presumed.
In rare cases, abone marrow biopsymight be necessary to rule out other causes of neutropenia. This typically occurs in children whose presentation and infections don’t fit the typical picture of pediatric autoimmune neutropenia.
What High and Low Neutrophils Mean on a Blood Test
Fever in a child with neutropenia may mean an infection has developed. If this happens, your child’s healthcare provider will do a CBC test. They may also order a blood culture to help identify the organism that’s causing the infection. During this test, a blood sample is placed in a glass bottle and checked for bacteria.
Treatment for pediatric neutropenia includes medication and, in some cases, bone marrow transplant.
Granulocyte Colony-Stimulating Factors
Granulocyte Colony-Stimulating Factors (G-CSFs) help the bone marrow make neutrophils. They may be able to help raise your child’s neutrophil levels and prevent infection.
Antibiotics
However, when a child with neutropenia develops a fever, it can be an indication of a developing infection. A child with neutropenia who has a fever will require immediate medical attention, which may include hospitalization. Treatment will focus on the cause of the infection, not on the neutropenia itself.
Because it is important to treat a potential infection quickly, your child may be given a broad-spectrum antibiotic before the cause of the fever is known.If a specific microbe is identified, the antibiotics may be altered to more specifically target the infection.
Your child’s CBC test will help their healthcare provider decide whether hospitalization is necessary. If your child’s ANC is less than 500 cells/mL, they will likely be admitted to the hospital on IV antibiotics for observation. Sometimes a medication called filgrastim (G-CSF) is used during active infections to stimulate the release of neutrophils from bone marrow to blood circulation.
If your child looks well and the ANC is greater than 1,000 cell/mL, they will likely be sent home for outpatient follow-up. Your child’s healthcare provider may recommend fever reducing medications to make your child more comfortable while they recover.
Because neutropenia increases the risk of infection, all fevers require medical evaluation.
Bone Marrow Transplant
Preventing Infections
A child with very low neutrophil counts is at high risk of infection. These children should take steps to avoid coming into contact with microorganisms that could cause infection. Some simple ways to prevent infection include:
An Overview of White Blood Cell Disorders
Summary
Pediatric neutropenia is a potentially serious condition that affects bacteria-fighting white blood cells called neutrophils. Children with this condition have low levels of neutrophils in their blood. This can lead to more frequent infections, which can sometimes be life-threatening.
Children with neutropenia may be diagnosed after a complete blood count is done as part of a diagnosis for a condition such as an ear or skin infection. Children with neutropenia are carefully monitored and may receive antibiotics or be admitted to the hospital for observation when they develop a fever.
Fortunately, neutropenia often resolves as a child gets older.
Yes. Cancers that affect bone marrow such as lymphomas and leukemia can cause low white blood cell counts. Chemotherapy or radiation can as well because they prevent white cells from being made in the bone marrow.Learn MoreWhat Is Bone Marrow?
Yes. Cancers that affect bone marrow such as lymphomas and leukemia can cause low white blood cell counts. Chemotherapy or radiation can as well because they prevent white cells from being made in the bone marrow.
Learn MoreWhat Is Bone Marrow?
In very rare cases, a treatment for severe chronic neutropenia known as G-CSF (a synthetic version of a hormone that stimulates bone marrow to produce neutrophils) has been associated with a small risk of pre-leukemia or leukemia.
Because the immune system may be weakened, some healthcare providers recommend avoiding foods that carry a risk of bacteria or foodborne illness. These include:
Learn MoreHow to Prevent E. Coli
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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