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Isolated Severe Neutropenia in Adults, Evaluation of Underlying Causes and Outcomes, Real-World Data Collected over a 5-Year Period in a Tertiary Referral Hospital
: In clinical practice, neutropenia is frequently accompanied by other cytopenia; isolated non-chemotherapy-induced severe neutropenia is less frequent and its differential diagnosis can be challenging. In this real-world study with data collected over a 5-year period in a tertiary referral hospital...
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| Published in: | Medicina (Kaunas, Lithuania) Lithuania), 2024-09, Vol.60 (10), p.1576 |
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| container_title | Medicina (Kaunas, Lithuania) |
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| creator | Njue, Linet Porret, Naomi Schnegg-Kaufmann, Annatina Sarah Varra, Luca Francesco Andres, Martin Rovó, Alicia |
| description | : In clinical practice, neutropenia is frequently accompanied by other cytopenia; isolated non-chemotherapy-induced severe neutropenia is less frequent and its differential diagnosis can be challenging. In this real-world study with data collected over a 5-year period in a tertiary referral hospital, we primarily sought to identify underlying causes of isolated severe neutropenia ( |
| doi_str_mv | 10.3390/medicina60101576 |
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/L). Secondly, we aimed to analyze its management and outcomes.
: From 444,926 screened patients, after exclusion of patients with chemotherapy, radiotherapy, hematological neoplasms, additional cytopenia, and benign ethnic neutropenia, we identified and analyzed data from 70 patients (0.015%) with isolated severe neutropenia. We thus confirmed that the occurrence of isolated severe neutropenia is a rare event, even in a tertiary hospital.
: The median age at diagnosis was 34 years (range 1-81) and 65% were female. Acute neutropenia was more frequently observed (n = 46/70, 65.7%); the main underlying causes in this group were drugs (n = 36/46, 78%) followed by infections (n = 10/46, 21.7%). We identified 24 (34.3%) patients with chronic neutropenia. The majority of them (n = 12/24, 50%) had an idiopathic form (CIN), 8/24 (33%) were autoimmune (AIN), and 4/24 (17%) were congenital.
: This study demonstrates the rarity and heterogeneity of isolated severe neutropenia and the steps to consider in its diagnostic work-up and management. Epidemiological characteristics, diagnostic work-up, and management including hospitalizations are described. Due to the high frequency of metamizole-induced neutropenia observed in this study, we want to raise awareness about its use, since this complication generates frequent hospitalizations even in young, otherwise healthy patients. Furthermore, recurrent infections in chronic forms of idiopathic neutropenia were quite common, suggesting a difference in phenotypes and need for therapy consideration depending on the clinical course.</description><identifier>ISSN: 1648-9144</identifier><identifier>ISSN: 1010-660X</identifier><identifier>EISSN: 1648-9144</identifier><identifier>DOI: 10.3390/medicina60101576</identifier><identifier>PMID: 39459363</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adolescent ; Adult ; Adults ; Aged ; Aged, 80 and over ; Autoimmune diseases ; Bacterial infections ; Blood tests ; Bone marrow ; Care and treatment ; Causes of ; Chemotherapy ; Child ; Child, Preschool ; congenital ; Congenital diseases ; Cytomegalovirus ; Dengue fever ; Diagnosis ; drugs ; Female ; Hematology ; Humans ; idiopathic ; Infant ; Infections ; Leukemia ; Male ; Middle Aged ; Mutation ; Neutropenia ; Neutropenia - epidemiology ; Neutrophils ; Pathogens ; Patients ; Retrospective Studies ; Tertiary Care Centers - statistics & numerical data ; Tumors ; Viral infections ; Womens health ; Young Adult</subject><ispartof>Medicina (Kaunas, Lithuania), 2024-09, Vol.60 (10), p.1576</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c441t-458ea56b3c75d49de60bdb5f27a20c1ddcb497e9a614465cb1ac38a3dac5cda73</cites><orcidid>0000-0002-2515-1935 ; 0000-0001-9891-2988 ; 0000-0002-7757-4753</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3120692204?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3120692204?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25751,27922,27923,37010,37011,38514,43893,44588,53789,53791,74182,74896</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39459363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Njue, Linet</creatorcontrib><creatorcontrib>Porret, Naomi</creatorcontrib><creatorcontrib>Schnegg-Kaufmann, Annatina Sarah</creatorcontrib><creatorcontrib>Varra, Luca Francesco</creatorcontrib><creatorcontrib>Andres, Martin</creatorcontrib><creatorcontrib>Rovó, Alicia</creatorcontrib><title>Isolated Severe Neutropenia in Adults, Evaluation of Underlying Causes and Outcomes, Real-World Data Collected over a 5-Year Period in a Tertiary Referral Hospital</title><title>Medicina (Kaunas, Lithuania)</title><addtitle>Medicina (Kaunas)</addtitle><description>: In clinical practice, neutropenia is frequently accompanied by other cytopenia; isolated non-chemotherapy-induced severe neutropenia is less frequent and its differential diagnosis can be challenging. In this real-world study with data collected over a 5-year period in a tertiary referral hospital, we primarily sought to identify underlying causes of isolated severe neutropenia (<0.5 × 10
/L). Secondly, we aimed to analyze its management and outcomes.
: From 444,926 screened patients, after exclusion of patients with chemotherapy, radiotherapy, hematological neoplasms, additional cytopenia, and benign ethnic neutropenia, we identified and analyzed data from 70 patients (0.015%) with isolated severe neutropenia. We thus confirmed that the occurrence of isolated severe neutropenia is a rare event, even in a tertiary hospital.
: The median age at diagnosis was 34 years (range 1-81) and 65% were female. Acute neutropenia was more frequently observed (n = 46/70, 65.7%); the main underlying causes in this group were drugs (n = 36/46, 78%) followed by infections (n = 10/46, 21.7%). We identified 24 (34.3%) patients with chronic neutropenia. The majority of them (n = 12/24, 50%) had an idiopathic form (CIN), 8/24 (33%) were autoimmune (AIN), and 4/24 (17%) were congenital.
: This study demonstrates the rarity and heterogeneity of isolated severe neutropenia and the steps to consider in its diagnostic work-up and management. Epidemiological characteristics, diagnostic work-up, and management including hospitalizations are described. Due to the high frequency of metamizole-induced neutropenia observed in this study, we want to raise awareness about its use, since this complication generates frequent hospitalizations even in young, otherwise healthy patients. Furthermore, recurrent infections in chronic forms of idiopathic neutropenia were quite common, suggesting a difference in phenotypes and need for therapy consideration depending on the clinical course.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autoimmune diseases</subject><subject>Bacterial infections</subject><subject>Blood tests</subject><subject>Bone marrow</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>congenital</subject><subject>Congenital diseases</subject><subject>Cytomegalovirus</subject><subject>Dengue fever</subject><subject>Diagnosis</subject><subject>drugs</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>idiopathic</subject><subject>Infant</subject><subject>Infections</subject><subject>Leukemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Neutropenia</subject><subject>Neutropenia - epidemiology</subject><subject>Neutrophils</subject><subject>Pathogens</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Tumors</subject><subject>Viral infections</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1648-9144</issn><issn>1010-660X</issn><issn>1648-9144</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUktvEzEQXiEQLYU7J2SJCwdS7PVj4xOKQqGRKoqgFeK0mrVngyvHTu3dSP09_FEcUkpTIR9szXyPmfFU1UtGjznX9N0KrTMugKKMMtmoR9UhU2I60UyIx_feB9WznK8o5bVs6qfVAddCaq74YfVrkaOHAS35hhtMSD7jOKS4xuCAuEBmdvRDfktONuBHGFwMJPbkMlhM_saFJZnDmDETCJacj4OJKyzorwh-8j0mb8kHGIDMo_doti6xmBAgcvIDIZEvmFy0Wx8gF5gGB-mmkHtMCTw5jXntBvDPqyc9-Iwvbu-j6vLjycX8dHJ2_mkxn51NjBBsmAg5RZCq46aRVmiLina2k33dQE0Ns9Z0QjeoQZWJKGk6BoZPgVsw0lho-FG12OnaCFftOrlVKaeN4No_gZiWLZQajcdWd3XTU6alaYSYKglNJxptqeqV6aTkRev9Tms9duWXDIahtLQnup8J7me7jJuWMUm1YroovLlVSPF6xDy0K5cNeg8B45hbzmpGVc3EtvDXD6BXcUyhzGqLokrXNRX_UEsoHbjQx2JstqLtbMoEbySdqoI6_g-qHIsrZ2LA3pX4HoHuCCbFnBP2d00y2m63tH24pYXy6v5w7gh_15L_Blt55PE</recordid><startdate>20240926</startdate><enddate>20240926</enddate><creator>Njue, Linet</creator><creator>Porret, Naomi</creator><creator>Schnegg-Kaufmann, Annatina Sarah</creator><creator>Varra, Luca Francesco</creator><creator>Andres, Martin</creator><creator>Rovó, Alicia</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2515-1935</orcidid><orcidid>https://orcid.org/0000-0001-9891-2988</orcidid><orcidid>https://orcid.org/0000-0002-7757-4753</orcidid></search><sort><creationdate>20240926</creationdate><title>Isolated Severe Neutropenia in Adults, Evaluation of Underlying Causes and Outcomes, Real-World Data Collected over a 5-Year Period in a Tertiary Referral Hospital</title><author>Njue, Linet ; Porret, Naomi ; Schnegg-Kaufmann, Annatina Sarah ; Varra, Luca Francesco ; Andres, Martin ; Rovó, Alicia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-458ea56b3c75d49de60bdb5f27a20c1ddcb497e9a614465cb1ac38a3dac5cda73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autoimmune diseases</topic><topic>Bacterial infections</topic><topic>Blood tests</topic><topic>Bone marrow</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>congenital</topic><topic>Congenital diseases</topic><topic>Cytomegalovirus</topic><topic>Dengue fever</topic><topic>Diagnosis</topic><topic>drugs</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>idiopathic</topic><topic>Infant</topic><topic>Infections</topic><topic>Leukemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Neutropenia</topic><topic>Neutropenia - epidemiology</topic><topic>Neutrophils</topic><topic>Pathogens</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><topic>Tumors</topic><topic>Viral infections</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Njue, Linet</creatorcontrib><creatorcontrib>Porret, Naomi</creatorcontrib><creatorcontrib>Schnegg-Kaufmann, Annatina Sarah</creatorcontrib><creatorcontrib>Varra, Luca Francesco</creatorcontrib><creatorcontrib>Andres, Martin</creatorcontrib><creatorcontrib>Rovó, Alicia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Medicina (Kaunas, Lithuania)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Njue, Linet</au><au>Porret, Naomi</au><au>Schnegg-Kaufmann, Annatina Sarah</au><au>Varra, Luca Francesco</au><au>Andres, Martin</au><au>Rovó, Alicia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Isolated Severe Neutropenia in Adults, Evaluation of Underlying Causes and Outcomes, Real-World Data Collected over a 5-Year Period in a Tertiary Referral Hospital</atitle><jtitle>Medicina (Kaunas, Lithuania)</jtitle><addtitle>Medicina (Kaunas)</addtitle><date>2024-09-26</date><risdate>2024</risdate><volume>60</volume><issue>10</issue><spage>1576</spage><pages>1576-</pages><issn>1648-9144</issn><issn>1010-660X</issn><eissn>1648-9144</eissn><abstract>: In clinical practice, neutropenia is frequently accompanied by other cytopenia; isolated non-chemotherapy-induced severe neutropenia is less frequent and its differential diagnosis can be challenging. In this real-world study with data collected over a 5-year period in a tertiary referral hospital, we primarily sought to identify underlying causes of isolated severe neutropenia (<0.5 × 10
/L). Secondly, we aimed to analyze its management and outcomes.
: From 444,926 screened patients, after exclusion of patients with chemotherapy, radiotherapy, hematological neoplasms, additional cytopenia, and benign ethnic neutropenia, we identified and analyzed data from 70 patients (0.015%) with isolated severe neutropenia. We thus confirmed that the occurrence of isolated severe neutropenia is a rare event, even in a tertiary hospital.
: The median age at diagnosis was 34 years (range 1-81) and 65% were female. Acute neutropenia was more frequently observed (n = 46/70, 65.7%); the main underlying causes in this group were drugs (n = 36/46, 78%) followed by infections (n = 10/46, 21.7%). We identified 24 (34.3%) patients with chronic neutropenia. The majority of them (n = 12/24, 50%) had an idiopathic form (CIN), 8/24 (33%) were autoimmune (AIN), and 4/24 (17%) were congenital.
: This study demonstrates the rarity and heterogeneity of isolated severe neutropenia and the steps to consider in its diagnostic work-up and management. Epidemiological characteristics, diagnostic work-up, and management including hospitalizations are described. Due to the high frequency of metamizole-induced neutropenia observed in this study, we want to raise awareness about its use, since this complication generates frequent hospitalizations even in young, otherwise healthy patients. Furthermore, recurrent infections in chronic forms of idiopathic neutropenia were quite common, suggesting a difference in phenotypes and need for therapy consideration depending on the clinical course.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39459363</pmid><doi>10.3390/medicina60101576</doi><orcidid>https://orcid.org/0000-0002-2515-1935</orcidid><orcidid>https://orcid.org/0000-0001-9891-2988</orcidid><orcidid>https://orcid.org/0000-0002-7757-4753</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Medicina (Kaunas, Lithuania), 2024-09, Vol.60 (10), p.1576 |
| issn | 1648-9144 1010-660X 1648-9144 |
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| source | Publicly Available Content Database; PubMed; Coronavirus Research Database |
| subjects | Adolescent Adult Adults Aged Aged, 80 and over Autoimmune diseases Bacterial infections Blood tests Bone marrow Care and treatment Causes of Chemotherapy Child Child, Preschool congenital Congenital diseases Cytomegalovirus Dengue fever Diagnosis drugs Female Hematology Humans idiopathic Infant Infections Leukemia Male Middle Aged Mutation Neutropenia Neutropenia - epidemiology Neutrophils Pathogens Patients Retrospective Studies Tertiary Care Centers - statistics & numerical data Tumors Viral infections Womens health Young Adult |
| title | Isolated Severe Neutropenia in Adults, Evaluation of Underlying Causes and Outcomes, Real-World Data Collected over a 5-Year Period in a Tertiary Referral Hospital |
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