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The epidemiology, clinical course and outcome of febrile cytopenia in children
Author(s) -
Alexandropoulou Ourania,
Kossiva Lydia,
Giannaki Maria,
Panagiotou JP,
Tsolia Maria,
Karavanaki Kyriaki
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12903
Subject(s) - cytopenia , medicine , pediatrics , pancytopenia , epidemiology , febrile neutropenia , neutropenia , gastroenterology , toxicity , bone marrow
Aim Transient infectious neutropenia of mild‐to‐moderate severity is common and resolves spontaneously within weeks. This was the first prospective study of the whole spectrum of febrile cytopenia in noncancer patients followed‐up for 2 years. It aimed to assess its aetiology, duration and outcome. Methods We evaluated 116 children with febrile cytopenia aged 4 ± 3.8 years, admitted to a paediatric ward over 2 years, using inflammatory markers, cultures and serological tests. Results An infectious agent was identified in 74 (63.8%) cases: 44.8% viral, 11.2% bacterial and 7.8% parasitic. One cell line was affected in 26.7% of patients and ≥2 cell lines in 73.3%. Cytopenia was transient in 82.75% of cases and chronic in 17.24%. The transient cytopenia subgroups – exhibited differences in severity (mild in bacterial cases and moderate in viral and parasitic cases, p = 0.018) and the number of affected cell lines, (predominantly two in viral and bacterial cases and pancytopenia in parasitic cases, p = 0.001). Chronic patients had severe cytopenia (p = 0.004) with ≥2 cell lines affected, while transient patients had mild‐to‐moderate cytopenia, with 1–3 cell lines affected. Conclusion Childhood febrile cytopenia is usually transient, of mild‐to‐moderate severity, and resolves spontaneously, but patients with severe cytopenia affecting ≥2 cell lines need further evaluation and follow‐up.