A step-by-step approach to paediatric neutropenia

Neutropenia is a common laboratory finding in children. The aetiology varies from benign transient post-viral suppression to overwhelming systemic disease. For medical providers, identification of the aetiology of neutropenia can be difficult, but clarification of the cause is important for determining management and prognosis. Neutropenia in children may be discovered during evaluation of a fever or illness, or may be found incidentally when a full blood count is undertaken for other reasons. It may be an isolated finding or may be associated with suppression of other cell lines. It is important to distinguish between transient or benign causes and severe congenital neutropenia or neutropenia associated with serious haematological or systemic disease. Appropriate advice and treatment must be given while further assessment and investigation take place. In this review, we will discuss how and where patients may present, initial management and investigation and when and with what urgency to refer to specialty care.