| Abstract | Neutropenija jest čest nalaz u pedijatrijskoj praksi. Cilj je ovoga rada ispitati demografske značajke, tijek i ishod neutropenije u 57 djece (30 dječaka i 27 djevojčica) liječene na Klinici za pedijatriju Kliničkog bolničkog centra Rijeka, tijekom desetogodišnjeg razdoblja (2012.-2021. godine). Onkološki su pacijenti s febrilnom neutropenijom isključeni iz istraživanja. Prosječna dob je bila 20,2 mjeseca (raspon 15 dana – 12,5 godina). Prosječno vrijeme od pojave neutropenije do upućivanja u bolnicu je bio 1,5 mjesec (raspon 1 dan – 9 mjeseci). Četrdeset (70,1%) pacijenata je imalo tešku neutropeniju, 14 (24,6%) umjerenu i 3 (5,3%) blagu. Prosječni apsolutni broj neutrofila (ABN) kod prijema je bio 507/μL (raspon 0 – 1410/μL). Kroničnu neutropeniju je imalo 50 (87,7%) pacijenata. Osamnaest (31,6%) pacijenata imalo je autoimunu neutropeniju, 9 (15,8%) postinfekcijsku, po 1 (1,8%) neonatalnu aloimunu, neonatalnu autoimunu i kongenitalnu neutropeniju, a u 27 (47,4%) pacijenata nije postavljena specifična dijagnoza. Tijekom neutropenije infekcije su zabilježene kod 20 (35,1%) djece od kojih je 12 (21,1%) bilo sklono ponovnim infekcijama. Granulocitni faktor rasta (G-CSF) primijenjen je kod 17 (29,8%) bolesnika s teškom neutropenijom. Niti jedno dijete nije profilaktički liječeno G-CSF ili antibioticima. Četrdeset i osam (84,2%) pacijenata se u potpunosti oporavilo. Srednje vrijeme do remisije je bilo 13 mjeseci (raspon 2 tjedna – 46 mjeseci). Medijan praćenja bio je 22,4 mjeseca (raspon 1 – 64 mjeseca). Iako većina djece s neutropenijom ima benigni tijek bolesti te ne zahtijeva liječničku intervenciju, preporuča se redovito praćenje svih pacijenata sve do postizanja remisije. |
| Abstract (english) | Neutropenia is frequently observed in pediatric practice. Aim of the study was to characterize demographic features, course and outcome of neutropenia in 57 children (30 boys and 27 girls) treated at the Pediatrics Clinic of the Clinical Hospital Center Rijeka, over a ten-year period (2012-2021). Oncology patients with febrile neutropenia were excluded from the study. The median age was 20.2 months (range 15 days - 12.5 years). The median time from the first evidence of neutropenia to the admission was 1.5 months (range 1 day – 9 months). Three (5.3%) patients were categorized as having mild neutropenia, 14 (24.6%) patients had moderate neutropenia, and 40 (70.1%) patients had severe neutropenia. The mean ANC at admission was 507/μL (range 0 – 1410/ μL). Chronic neutropenia was present in 50 (87.7%) patients. Eighteen (31.6%) patients had autoimmune neutropenia, 9 (15.8%) postinfectious, 1 (1.8%) neonatal alloimmune, 1 (1,8%) neonatal autoimmune, and 1 (1,8%) congenital neutropenia. A specific diagnosis was not established in 27 (47,4%) children. Infections was recorded in 20 (35,1%) children during neutropenia, among whom 12 (21,1%) were prone to recurrent infections. Granulocyte-colony stimulating factor (G-CSF) was administered to 17 (29.8%) patients with severe neutropenia. No children were prophylactically treated with G-CSF or antibiotics. Forty-eight (84,2%) patients fully recovered. The median time to resolution was 13 months (range 2 weeks – 46 months). The median follow-up was 22.4 months (range 1 – 64 months). Although majority of children with neutropenia have benign course of the disease thus not requiring medical intervention, we suggest monitoring of all patients until the resolution of the disease. |
