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Acta Paediatr. 2015 Mar;104(3):e112-8. doi: 10.1111/apa.12903.

The epidemiology, clinical course and outcome of febrile cytopenia in children.

Author information

1
2nd Department of Paediatrics, University of Athens, 'P&A Kyriakou' Children's Hospital, Athens, Greece.

Abstract

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.

KEYWORDS:

Children; Cytopenia; Fever; Infections

PMID:
25521519
DOI:
10.1111/apa.12903
[Indexed for MEDLINE]

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