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Published in: BMC Hematology 1/2016

Open Access 01-12-2016 | Research article

Prevalence of neutropenia in children by nationality

Authors: Srdjan Denic, Hassib Narchi, Lolowa A. Al Mekaini, Suleiman Al-Hammadi, Omar N. Al Jabri, Abdul-Kader Souid

Published in: BMC Hematology | Issue 1/2016

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Abstract

Background

A high prevalence of neutropenia has been reported in several ethnic groups amongst whom many healthy individuals with low neutrophil counts undergo unnecessary investigations. This study aims to ascertain the prevalence of neutropenia (NP) in a large cohort of children from North African, Middle Eastern, and Asian countries residing in the United Arab Emirates.

Methods

Neutrophil counts of 26,542 children (one day to six years of age) from 86 countries were analyzed. The subjects were enrolled in the Well-Child-Care program of Ambulatory Health Services of Emirate of Abu Dhabi, United Arab Emirates. NP was defined as a neutrophil count <1.5 × 109/L and severe NP <0.5 × 109/L.

Results

The neutrophil counts reached a nadir in the fourth week of life and changed slightly from the age of six-months to six-years. The frequency of NP was (from West-to-East): North African Arabs 15.4 %, Green Crescent Arabs 9.8 %, Peninsular Arabs 10.9 %, Iranians 3.1 %, Afghanis 2.5 %, Pakistanis 5.6 %, Indians 10.2 %, and Filipinos 7.3 %. The frequency of severe NP in North African Arabs (Sudanese) was 2.8 %, Green Crescent and Peninsular Arabs ≤1 %, Indians 1.5 %, and Filipinos 1.8 %. In 12,703 Emirati children, the frequency of NP was 10.6 % similar to their adult counterparts.

Conclusion

The prevalence of childhood NP varied considerably by geoethnicity. Measures to prevent the inappropriate investigations of healthy children with benign neutropenia are proposed.
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Literature
1.
go back to reference Haddy TB, Rana SR, Castro O. Benign ethnic neutropenia: What is a normal absolute neutrophil count? J Lab Clin Med. 1999;133:15–22.CrossRefPubMed Haddy TB, Rana SR, Castro O. Benign ethnic neutropenia: What is a normal absolute neutrophil count? J Lab Clin Med. 1999;133:15–22.CrossRefPubMed
3.
go back to reference Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP. Prevalence of neutropenia in the U.S. population: Age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007;146:486–92.CrossRefPubMed Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP. Prevalence of neutropenia in the U.S. population: Age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007;146:486–92.CrossRefPubMed
4.
go back to reference Jumean HG, Sudah FI. Chronic benign idiopathic neutropenia in Jordanians. Acta haemat. 1983;69:59–60.CrossRefPubMed Jumean HG, Sudah FI. Chronic benign idiopathic neutropenia in Jordanians. Acta haemat. 1983;69:59–60.CrossRefPubMed
5.
go back to reference Kaab SA, Fadhli SA, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunology Letter. 2004;91:49–53.CrossRef Kaab SA, Fadhli SA, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunology Letter. 2004;91:49–53.CrossRef
6.
go back to reference Shoenfeld Y, Alkan ML, Asaly A, Carmell Y, Katz M. Benign familial leucopenia and neutropenia in different ethnic groups. Eur J Haematol. 1988;41:273–7.CrossRefPubMed Shoenfeld Y, Alkan ML, Asaly A, Carmell Y, Katz M. Benign familial leucopenia and neutropenia in different ethnic groups. Eur J Haematol. 1988;41:273–7.CrossRefPubMed
7.
go back to reference Denic S, Showqi S, Klein C, Takala M, Nagelkerke N, Agarwal MM. Prevalence, phenotype and inheritance of benign neutropenia in Arabs. BMC Blood Disord. 2009;9:3.PubMedPubMedCentral Denic S, Showqi S, Klein C, Takala M, Nagelkerke N, Agarwal MM. Prevalence, phenotype and inheritance of benign neutropenia in Arabs. BMC Blood Disord. 2009;9:3.PubMedPubMedCentral
8.
go back to reference Weingarten MA, Pottick-Schwartz EA, Brauner A. The epidemiology of benign leucopenia in Yemenite Jews. Isr J Med Sci. 1993;29:297–9.PubMed Weingarten MA, Pottick-Schwartz EA, Brauner A. The epidemiology of benign leucopenia in Yemenite Jews. Isr J Med Sci. 1993;29:297–9.PubMed
9.
go back to reference Grann VR, Ziv E, Joseph CK, Neugut AI, Wei Y, Jacobson JS, et al. Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean. Br J Haemat. 2008;143:288–93.CrossRef Grann VR, Ziv E, Joseph CK, Neugut AI, Wei Y, Jacobson JS, et al. Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean. Br J Haemat. 2008;143:288–93.CrossRef
10.
go back to reference Kelly DL, Kreyenbuhl J, Dixon L, et al. Clozapine underutilization and discontinuation in African Americans due to leucopenia. Schizophr Bull. 2007;33:1221–4.CrossRefPubMed Kelly DL, Kreyenbuhl J, Dixon L, et al. Clozapine underutilization and discontinuation in African Americans due to leucopenia. Schizophr Bull. 2007;33:1221–4.CrossRefPubMed
11.
go back to reference Kuno E, Rothbard AB. Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiatry. 2002;159:567–72.CrossRefPubMed Kuno E, Rothbard AB. Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiatry. 2002;159:567–72.CrossRefPubMed
12.
go back to reference Smith K, Wray L, Klein-Cabral M, Schuchter L, Fox K, Glick J, et al. Ethnic disparities in adjuvant chemotherapy for breast cancer are not caused by excess toxicity in black patients. Clin Breast Cancer. 2005;6:260–6.CrossRefPubMed Smith K, Wray L, Klein-Cabral M, Schuchter L, Fox K, Glick J, et al. Ethnic disparities in adjuvant chemotherapy for breast cancer are not caused by excess toxicity in black patients. Clin Breast Cancer. 2005;6:260–6.CrossRefPubMed
13.
go back to reference Hershman D, Weinberg M, Rosner Z, et al. Ethnic neutropenia and treatment delay in African American women undergoing chemotherapy for early-stage breast cancer. J Natl Cancer Inst. 2003;15:1545–8.CrossRef Hershman D, Weinberg M, Rosner Z, et al. Ethnic neutropenia and treatment delay in African American women undergoing chemotherapy for early-stage breast cancer. J Natl Cancer Inst. 2003;15:1545–8.CrossRef
14.
go back to reference Melia MT, Muir AJ, McCone J, Shiffman ML, King JW, Herrine SK, et al. Racial differences in hepatitis C treatment eligibility. Hepatology. 2011;54:70–8.CrossRefPubMedPubMedCentral Melia MT, Muir AJ, McCone J, Shiffman ML, King JW, Herrine SK, et al. Racial differences in hepatitis C treatment eligibility. Hepatology. 2011;54:70–8.CrossRefPubMedPubMedCentral
15.
go back to reference van Rooijen CR, Slieker WA, Simsek S. Benign ethnic neutropenia; an unrecognized cause of leukopenia in negroid patients. Ned Tijdschr Geneeskd. 2012;156:A4708.PubMed van Rooijen CR, Slieker WA, Simsek S. Benign ethnic neutropenia; an unrecognized cause of leukopenia in negroid patients. Ned Tijdschr Geneeskd. 2012;156:A4708.PubMed
16.
go back to reference Eller LA, Eller MA, Ouma B, Kataaha P, Kyabaggu D, Tumusiime R, et al. Reference intervals in healthy adult Ugandan blood donors and their impact on conducting international vaccine trials. Plos One. 2008;3:e3919.CrossRefPubMedPubMedCentral Eller LA, Eller MA, Ouma B, Kataaha P, Kyabaggu D, Tumusiime R, et al. Reference intervals in healthy adult Ugandan blood donors and their impact on conducting international vaccine trials. Plos One. 2008;3:e3919.CrossRefPubMedPubMedCentral
17.
go back to reference Denic S, Nicholls MG. A call for screening for benign neutropenia in Arab populations. Saudi Medical Journal. 2011;32:738–9.PubMed Denic S, Nicholls MG. A call for screening for benign neutropenia in Arab populations. Saudi Medical Journal. 2011;32:738–9.PubMed
18.
go back to reference Heard-Bey F. The tribal society of the UAE and its traditional economy. In: Al Abed I, Hellyer P, editors. United Arab Emirates: A new perspective. London: Trident Press; 2001. p. 98–116. Heard-Bey F. The tribal society of the UAE and its traditional economy. In: Al Abed I, Hellyer P, editors. United Arab Emirates: A new perspective. London: Trident Press; 2001. p. 98–116.
19.
go back to reference Al-Gazali IL, Bener A, Abdulrazzaq MY, Micallef R, Al Khayat AI, Gaber T. Consanguineous marriages in the United Arab Emirates. J Biosoc Sci. 1997;29:491–7.CrossRefPubMed Al-Gazali IL, Bener A, Abdulrazzaq MY, Micallef R, Al Khayat AI, Gaber T. Consanguineous marriages in the United Arab Emirates. J Biosoc Sci. 1997;29:491–7.CrossRefPubMed
20.
go back to reference Denic S. Aden B, Nagelkerke N, Al Essa A. Beta-thalassemia in Abu Dhabi: Consanguinity and tribal stratification are major factors explaining the high prevalence of disease. Hemoglobin. 2013. Early Online: 1–8. Denic S. Aden B, Nagelkerke N, Al Essa A. Beta-thalassemia in Abu Dhabi: Consanguinity and tribal stratification are major factors explaining the high prevalence of disease. Hemoglobin. 2013. Early Online: 1–8.
21.
go back to reference Gillespie JH. Population Genetics: A Concise Guide Baltimore. Baltimore: The John Hopkins Univ Press; 1998. Gillespie JH. Population Genetics: A Concise Guide Baltimore. Baltimore: The John Hopkins Univ Press; 1998.
22.
23.
go back to reference Aldrimer M, Ridefelt P, Rödöö P, Niklasson F, Gustafsson J, Hellberg D. Population-based pediatric reference intervals for hematology, iron and transferrin. Scand J Clin Lab Invest. 2013;73:253–61.CrossRefPubMed Aldrimer M, Ridefelt P, Rödöö P, Niklasson F, Gustafsson J, Hellberg D. Population-based pediatric reference intervals for hematology, iron and transferrin. Scand J Clin Lab Invest. 2013;73:253–61.CrossRefPubMed
24.
go back to reference Ahsan S, Noether J. Hematology, Chapter 14. In: The Harriet Lane. Philadelphia: Elsevier Mosby; 2011. p. 322–53. Ahsan S, Noether J. Hematology, Chapter 14. In: The Harriet Lane. Philadelphia: Elsevier Mosby; 2011. p. 322–53.
26.
go back to reference Sandler SG, Kravitz C, Sharon R, Hermoni D, Ezekiel E, Cohen T. The Duffy blood group system in Israeli Jews and Arabs. Vox Sanguinis. 1979;37:41–6.CrossRefPubMed Sandler SG, Kravitz C, Sharon R, Hermoni D, Ezekiel E, Cohen T. The Duffy blood group system in Israeli Jews and Arabs. Vox Sanguinis. 1979;37:41–6.CrossRefPubMed
27.
go back to reference Anita C, Sujata M, Yogesh Kumar J, Aparup D. Natural Selection Mediated Association of the Duffy (FY) Gene Polymorphisms with Plasmodium vivax Malaria in India. Plos One. 2012;7:e45219.CrossRef Anita C, Sujata M, Yogesh Kumar J, Aparup D. Natural Selection Mediated Association of the Duffy (FY) Gene Polymorphisms with Plasmodium vivax Malaria in India. Plos One. 2012;7:e45219.CrossRef
28.
go back to reference Peng CT, Tsai CH, Lee HH, Lin CL, Wang NM, Chang JG. Molecular analysis of Duffy, Yt and Colton blood groups in Taiwanese, Filipinos and Thais. Kaohsiung J Med Sci. 2000;16:63–7.PubMed Peng CT, Tsai CH, Lee HH, Lin CL, Wang NM, Chang JG. Molecular analysis of Duffy, Yt and Colton blood groups in Taiwanese, Filipinos and Thais. Kaohsiung J Med Sci. 2000;16:63–7.PubMed
29.
go back to reference Reiner AP, Lettre G, Nalls MA, Ganesh SK, Mathias R, et al. Genome-Wide Association Study of White Blood Cell Count in 16,388 African Americans: the Continental Origins and Genetic Epidemiology Network (COGENT). PLoS Genet. 2011;7(6):e1002108.CrossRefPubMedPubMedCentral Reiner AP, Lettre G, Nalls MA, Ganesh SK, Mathias R, et al. Genome-Wide Association Study of White Blood Cell Count in 16,388 African Americans: the Continental Origins and Genetic Epidemiology Network (COGENT). PLoS Genet. 2011;7(6):e1002108.CrossRefPubMedPubMedCentral
30.
go back to reference Thobakgale FC, Ndung’u T. Neutrophil counts in persons of African origin. Curr Opin Hematol. 2014;21:50–7.CrossRefPubMed Thobakgale FC, Ndung’u T. Neutrophil counts in persons of African origin. Curr Opin Hematol. 2014;21:50–7.CrossRefPubMed
31.
go back to reference Bux J, Kissel K, Nowak K, Spengel U, Mueller-Eckhardt C. Autoimmune neutropenia: clinical and laboratory studies in 143 patients. Ann Hematol. 1991;63:249–52.CrossRefPubMed Bux J, Kissel K, Nowak K, Spengel U, Mueller-Eckhardt C. Autoimmune neutropenia: clinical and laboratory studies in 143 patients. Ann Hematol. 1991;63:249–52.CrossRefPubMed
32.
go back to reference Coşkun O, Avci IY, Sener K, Yaman H, Ogur R, Bodur H, et al. Relative lymphopenia and monocytosis may be considered as a surrogate marker of pandemic influenza a (H1N1). J Clin Virol. 2010;47:388–9.CrossRefPubMed Coşkun O, Avci IY, Sener K, Yaman H, Ogur R, Bodur H, et al. Relative lymphopenia and monocytosis may be considered as a surrogate marker of pandemic influenza a (H1N1). J Clin Virol. 2010;47:388–9.CrossRefPubMed
33.
go back to reference Chung BH, Chan GC, Lee T, Kwok JS, Chiang AK, Ho HK, et al. Chronic benign neutropenia among Chinese children. Hong Kong Med J. 2004;10:231–6.PubMed Chung BH, Chan GC, Lee T, Kwok JS, Chiang AK, Ho HK, et al. Chronic benign neutropenia among Chinese children. Hong Kong Med J. 2004;10:231–6.PubMed
34.
go back to reference Nathan C. Neutrophils and immunity: challenges and opportunities. Nature Rev Imm. 2006;6:173–82.CrossRef Nathan C. Neutrophils and immunity: challenges and opportunities. Nature Rev Imm. 2006;6:173–82.CrossRef
35.
go back to reference Nguyen PH, Day N, Pram TD, Ferguson DJ, White NJ. Intraleucocytic malaria pigment and prognosis in severe malaria. Trans R Soc Trop Med Hyg. 1995;89:200–4.CrossRefPubMed Nguyen PH, Day N, Pram TD, Ferguson DJ, White NJ. Intraleucocytic malaria pigment and prognosis in severe malaria. Trans R Soc Trop Med Hyg. 1995;89:200–4.CrossRefPubMed
Metadata
Title
Prevalence of neutropenia in children by nationality
Authors
Srdjan Denic
Hassib Narchi
Lolowa A. Al Mekaini
Suleiman Al-Hammadi
Omar N. Al Jabri
Abdul-Kader Souid
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Hematology / Issue 1/2016
Electronic ISSN: 2052-1839
DOI
https://doi.org/10.1186/s12878-016-0054-8

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