Low neutrophil count in children

If a child only shows low neutrophil count during examination, timely treatment is necessary. Most of the causes of this condition are congenital, which makes treatment very troublesome. Long-term treatment may be required for improvement, and there are certain genetic factors involved, which requires special attention.

There are many causes of neutropenia. There are different classification methods. It can be divided into congenital or acquired, or it can be divided into five categories according to decreased granulocyte production, ineffective proliferation, excessive destruction, combined causes and pseudogranulocytopenia:

(I) Decreased granulocyte production or maturation arrest

1. The drug acts directly on the bone marrow

Common ones include methotrexate, 6-mercaptopurine, and alkylating agents such as cyclophosphamide. Among antibiotics, chloramphenicol is the most common cause of granulocytopenia.

2. The role of radioactive substances

Radiation therapy to the spine, pelvis, sternum and other parts can affect the hematopoietic function of the bone marrow and cause granulocytopenia.

3. Hereditary neutropenia

Also known as infantile lethal neutropenia, it is a rare neutropenia that is inherited in an autosomal recessive manner.

4. Reticular dysgenesis with congenital leukocytosis

This disease is extremely rare. The disease occurs immediately after birth. The thymus, systemic lymph nodes, tonsils, and intestinal lymph nodes are all underdeveloped or stunted. The number of lymphocytes in the peripheral blood is extremely reduced, cellular immunity is low, and plasma gamma globulin is reduced. The disease is caused by defects in the development of hematopoietic stem cells. Granulocytosis is hypoplastic, with a lack of primitive granulocytes and monocytes in the bone marrow, while the erythroid and megakaryocyte systems are normal. Death often occurs in infancy from severe bacterial or viral infections.

5. Neutropenia with dysimmunoglobulinemia

About half of the children have a family history and the disease is sex-linked. The prognosis is poor, and most people die within a few years of life.

6. Familial benign chronic neutropenia

It is an autosomal dominant or recessive trait and is more common in African and Jewish families. The prognosis is good.

7. Familial severe neutropenia

The disorder may be inherited in an autosomal recessive or dominant manner.