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 Vol. 10 No. 9, September 2009
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NeoReviews Vol.10 No.9 2009 e446
© 2009 American Academy of Pediatrics

Immune-mediated Neutropenia in the Neonate

L. Vandy Black, MD*
Akhil Maheshwari, MD{dagger}

* Instructor, Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Ala
{dagger} Assistant Professor of Pediatrics, Cell Biology, and Pathology, Divisions of Neonatology and Pediatric Gastroenterology, University of Alabama at Birmingham, Birmingham, Ala

Neutropenia is a relatively common finding in ill neonates, occurring in approximately 32,000 infants each year in the United States. In this patient population, immune-mediated neutropenia results from the antibody-mediated destruction of neutrophils and is associated with such disorders as alloimmune neonatal neutropenia, neonatal autoimmune neutropenia, and autoimmune neutropenia of infancy. Such conditions only recently have begun to be understood and often are problematic in terms of clinical identification and laboratory confirmation. This article reviews the clinical presentation, laboratory diagnosis, and treatment options for these three disorders.

Abbreviations: AINI: autoimmune neutropenia of infancy • ANN: alloimmune neonatal neutropenia • GAT: granulocyte agglutination test • G-CSF: granulocyte-colony-stimulating factor • GIFT: granulocyte immunofluorescence test • HNA: human neutrophil alloantigen • Ig: immunoglobulin • IVIG: intravenous immune globulin • MIAGA: monoclonal antibody immobilization of granulocyte antigens • NICU: neonatal intensive care unit • rhG-CSF: recombinant human granulocyte-colony-stimulating factor • SCN: severe congenital neutropenia


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