More common cause of chronic neutropenia in children, also known as autoimmune neutropenia. This isolated neutropenia is most often discovered during an infectious episode of moderate severity. It occurs generally in  a small child (median age of discovery: 8 months). Monocytosis, eosinophilia or a moderate splenomegaly can olso be associated.

Neutropenia is permanent, sometimes profound, but its tolerance is often good. The myelogram shows hyperplasia of the myeloid precursors and late stage blockade of their maturation.

The detection of the anti-polynuclear antibodies requires repeated examinations (approximately 75 % of cases are detected at first examination). The autoimmune process involves one of the glycoproteins of the polynuclear cells cellular membrane. The most frequently involved glycoprotein is the receptor for the constant fragments of the gammaglobulins (FcRgIIIb) or CD16, which is present in the form of two codominant alleles (HNA-1a and HNA-1b, formerly NA1 and NA2). The neutropenia disappears occurs spontaneously within a period of 12 to 24 months, exceptionally 36 months.

Anesthetic implications:

check blood leucocytes, platelets and red blood cells

References : 

Updated: June 2019