جستجوی مقالات مرتبط با کلیدواژه "neutropenia" در نشریات گروه "پزشکی"

Context: 

It's crucial to monitor hematologic biomarkers in patients with coronavirus disease 2019 (COVID-19) to identify abnormalities and guide treatment decisions. These biomarkers provide valuable information about the severity of the disease and assist healthcare providers in making informed decisions about patient care.

Evidence Acquisition: 

The present study reviewed the most recent literature on hematologic biomarker abnormalities in patients with COVID-19 and considered their clinical significance.

Various abnormalities were observed in hematologic biomarkers, including prothrombin time (PT), partial thromboplastin time (PTT), red blood cell indices, interferon regulatory factor (IRF-7), and white blood cell (WBC) count. Notably, significant lymphocytopenia, thrombocytopenia, and leukocytosis were reported in patients with severe and fatal COVID-19 compared to those with non-severe disease and survivors.

Hematologic biomarkers play a crucial role in understanding COVID-19 pathogenesis and guiding clinical management. Utilizing these markers allows clinicians to assess disease severity, predict prognosis, and tailor treatment strategies to improve patient outcomes. Continued research in this area is essential to fully realize the potential of hematologic biomarkers for COVID-19 management.

 Invasive fungal infection (IFI) is a life-threatening condition, particularly in individuals with compromised immune systems.

 Our study aims to evaluate IFI in hospitalized patients with hematological malignancies.

 In this retrospective cross-sectional study, we evaluated patients with hematological malignancies admitted to two university hospitals in Tehran, Iran, from 2020 to 2021 for IFI. We selected only those patients who had been hospitalized for at least four days for antimicrobial treatment. Data analysis was conducted using SPSS-26 software, employing Mann-Whitney U, chi-square, and Fisher exact tests.

 During the study period, 60 out of 213 patients with hematological malignancies were admitted for antimicrobial treatment. The average age of the patients was 57.1 years, with fever being the most common symptom, reported in 63.3% of cases. We identified 24 cases of
IFI, including three proven cases (Candida spp.) and 21 probable cases. Statistical analysis showed a lower mean neutrophil count in the IFI group compared to the non-IFI group (3862 versus 12881, P = 0.001) and a higher mortality rate (58.3% versus 27.8%, P = 0.031).

 Our study revealed that severe neutropenia is a significant risk factor for IFI, and the mortality rate associated with IFI remains high despite advances in the treatment of hematological malignancies.

This study explores the link between inflammatory markers and hospital outcomes in febrile neutropenic patients with solid cancers- a complication caused by systemic chemotherapy that can lead to hospitalization and requires timely diagnosis and treatment to reduce fatalities.

This study was conducted in 2017 at Vali-e-Asr Hospital in Birjand with 22 participants. Blood samples were collected to measure inflammatory indexes. The study documented various hospital outcomes, including duration of neutropenia and fever correction, length of hospital stays, ICU admission or mechanical ventilation, and mortality. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each marker.

According to the findings, there was no significant difference in the mean duration of neutropenia, the duration of fever, or the length of hospital stay comparing procalcitonin (PCT; P = 0.96, P = 0.36, P = 0.66, respectively), polymorphonuclears (PMNs; P = 0.11, P = 0.94, P = 0.52, respectively), and erythrocyte sedimentation rate (ESR; P = 0.41, P = 0.24, P = 0.17, respectively). Further, the performance metrics calculated for PCT, ESR, and PMNs were an accuracy of 50%, 50%, and 40.90%, sensitivity of 88.8%, 100%, and 88.8%, specificity of 23.07%, 15.38%, and 7.6%, PPV of 44.4%, 45%, and 40%, and NPV of 75%, 100%, and 50%, respectively.

Our findings suggested that there was no significant relationship between inflammatory factors and hospital outcomes. However, further research is needed to explore the prognostic value of these markers in a larger and more diverse patient population.

Resistant schizoaffective disorder has persistent psychotic symptoms and intermittent mood swings. A satisfying method for treating these patients is the use of the antipsychotic drug clozapine, but its use is limited due to significant side effects such as leukopenia and neutropenia. Lithium carbonate is another psychiatric drug that reduces these side effects. We hypothesized that lithium, along with clozapine, in addition to controlling side effects, could have a dual effect on mood episodes in schizoaffective disorder, and used it in a chronic case. The patient was a 48-year-old man with a 20-year history of the disease. Therefore, the use of lithium along with clozapine is recommended in refractory schizoaffective patients.

Severe congenital neutropenias (SCNs) are the rare heterogenous group of preleukemia bone marrow failure syndromes characterized by impaired differentiation of neutrophilic granulocytes and, as a result, severe chronic neutropenia. Patients with SCN are predisposed to recurrent, often life-threatening bacterial and/or fungal infections beginning in the first months of life. Molecular abnormalities in 10 genes have been identified that are responsible for SCNs. The pathophysiological mechanisms of SCNs are the subject of extensive investigation and are not fully known. The current review aims to summarize the studies exploring the biological role of SCN-associated genes and the effects of mutant genes in neutropenia pathogenesis. We mainly focus on the genetic mutations that lead to SCN1 to SCN9 and X-linked SCN (XSCN) to shed more light on the pathophysiology of these diseases.

 Viral infections are the most common cause of fever and neutropenia in children without underlying disease, and data are still limited in this regard.

 This study aimed to identify the most common viral causes of fever and neutropenia in pediatrics.

 This descriptive-analytical study was conducted on pediatric patients younger than 18 years old referred to the pediatric emergency ward with fever as the chief complaint and no underlying diseases; patients with neutropenia and no evidence of bacterial infections in terms of different cultures were included in the study. After obtaining parental consent, nasopharyngeal swab specimens were taken from patients during the coronavirus disease 2019 (COVID-19) pandemic, and blood samples were analyzed to detect viruses in each patient.

 Fifty patients (54.3%) had mild neutropenia (absolute neutrophil count (ANC): 1000 - 1500/μL), 40 patients (43.5%) had moderate neutropenia (ANC: 1000 - 500/μL), and 2 cases (2.2%) had severe neutropenia (ANC < 500/μL). Among all the cases, 19 cases were positive in terms of virus examination, including adenovirus (6.5%), enterovirus (5.4%), cytomegalovirus (CMV) (3.3%), Epstein-Barr virus (EBV) (3.3%), and Herpes virus 6 (2.2%). A significant correlation was found between enterovirus and neutropenia (P = 0.005).

 The most common viruses found in neutropenic children hospitalized due to fever without any underlying disease were adenovirus and enterovirus, respectively. Considering the good general condition and relatively quick recovery, consideration of viral causes is recommended in this category of patients, and it is better to avoid prescribing broad-spectrum antibiotics, and careful follow-up should be carried out.

Altered immune responses, in particular neutrophil changes, are perceived to play a key role in immuneresponses to trauma. This study aimed to evaluate the association of neutrophil changes with patients’ survival in severetrauma cases.

The current retrospective cohort study was conducted using data from patients admitted in theintensive care unit (ICU) of a trauma center in Shiraz, Iran, between 2016 and 2021. Patients were divided into threegroups (i.e., normal, neutropenia, and neutrophilia) based on neutrophil count at the time of ICU admission, and theassociation of neutrophil count with in-hospital mortality was analyzed.

2176 patients with the mean age of37.90 ± 18.57 years were evaluated (84.04% male). The median trauma severity based on injury severity score (ISS) in thisseries was 9 (4 -17). Patients were divided in to three groups of neutrophilia (n = 1805), normal (n = 357), and neutropenia(n = 14). There were not any significant differences between groups regarding age distribution (p = 0.634), gender (p =0.544), and trauma severity (p = 0.197). The median survival times for the normal, neutropenia, and neutrophilia groupswere 49 (IQR: 33 -47) days, 51 (IQR: 8- 51) days, and 38 (IQR: 26 - 52) days, respectively (p = 0.346). The log-rank testshowed a statistically significant difference between the three groups adjustment for ISS (p≤0.001). For each unitincrease in ISS, the hazard ratio increased by 2%. In ISS 9-17, the hazard ratio increased by 11% compared to ISS<4. Also,in ISS>17, the hazard ratio increased by 76% compared to ISS<4 in ICU-hospitalized patients.

In general,the findings of the present study showed that the survival rate of patients in the normal group after ISS adjustment washigher than the other two groups. Also, the Cox model showed that the mortality risk ratio in the neutropenia group was15 times higher than the normal group.

Manyaspects of the severe acute respiratorysyndrome coronavirus 2 (SARSCoV2)pandemicin 2019 have been unclear, especially in newborns, and reports of neonatal diseases are usually associated with perinatal infection.

The purpose of this study was to evaluate clinical and para-clinical manifestations in newborns that contracted the infection after birth.

This observational research was conducted from October 2020 to March 2022 to examine postnatal SARSCoV2 infection in infants admitted to the NICU or neonatal ward at the Children’s Medical Center in Tehran, Iran. Inclusion in the study was open to neonates who had positive RT-PCR results postnatally.

In total, 55 newborns were confirmed to have postnatal SARSCOV2. Fever was the most frequently observed symptom, with 35 (61%). Necrotizing enterocolitis was seen in 18% of neonates, and 30% of them were preterm. Neutropenia was seen in 34% of cases, with five cases having severe neutropenia. All neonates had a normal platelet count. Twenty percent of patients showed C - reactive protein higher than 6 mg/L. Two newborns had co-existing bacterial urinary tract infections. Our neonates didn’t require antiviral, anticoagulant, or corticosteroid medications, and they recovered while receiving only supportive care. Everyone in the group of newborns was discharged without complications, and there were no deaths.

The high rate of fever, high C- reactive protein, and neutropenia in SARSCoV2 neonates suggests that more observational research is needed to compare these symptoms to bacterial sepsis to avoid the overuse of antibiotics in these patients.

 Neutropenia is a common side effect of chemotherapy and one of the most common causes of severe infection and mortality in patients with hematological malignancies. Some studies showed that antimicrobial prophylaxis resulted in lower febrile neutropenia (FN) episodes and mortality rates.

 We aimed to determine the efficacy of prophylaxis with ciprofloxacin in patients with hematological malignancies.

 In a randomized double-blinded clinical trial from 1 March to 1 September 2016, we assigned patients with chemotherapy-induced neutropenia into two groups. We used the random permuted blocks method for randomization. The first group received oral ciprofloxacin at a dose of 500 milligrams daily until the neutrophil count reached 1000 cells per microliter or fever occurrence, defined as the primary outcome. The second group received a placebo in the same shape and size. We compared FN episodes and the mortality rate in these two groups by SPSS-22 software, using chi-square, Fischer's exact tests, and student t-test at P-value < 0.05.

 Seventy-three males (60.8%) and 47 females (39.2%) entered our study. The mean age of the patients was 47 ± 14.6 years. Acute leukemia was the most common underlying malignancy in 81 out of 120 subjects (67.5%). Fever (P = 0.005) was significantly lower in the ciprofloxacin group, but the mortality rate (P = 0.783) did not differ between the two groups.

 We found that the prophylaxis with ciprofloxacin decreased FN in our patients but did not influence the mortality rate. We believe that antimicrobial prophylaxis may be helpful in neutropenic patients, especially in decreasing FN and its related comorbidity.

 Invasive fungal infections are among the most important causes of death in patients with neutropenic fever. Early detection of the cause of neutropenia and appropriate treatment, including experimental antifungal therapy, plays a key role in reducing mortality and cutting financial costs for the individual and society.

 In this retrospective study, the records of 33 patients with fever and neutropenia who received antifungal drugs (including Amphotericin B, Voriconazole, Caspofungin, and Fluconazole) were evaluated. Neutropenia was defined as episodes of fever (axillary temperature > 38.2°C or oral temperature > 37.7°C) and neutrophil count < 500 /μL persistent for five days despite antibacterial therapy without an infectious etiology. For statistical analysis, SPSS software version 21 was used.

 In this study, out of 33 neutropenic patients receiving antifungal therapy, a fungal agent was defined in 19 patients (59%). Mucor species was the most common cause of fungal infections, followed by aspergillus and candida. Liposomal Amphotericin B and Caspofungin were the most common antifungal agents used for treating patients with neutropenic fever. Antifungal therapy in neutropenic patients resulted in 50% recovery and 50% mortality. Statistical analysis showed that neutropenic patients did not have a significant difference in response to treatments based on age groups and gender.

 The study highlights the importance of experimental therapy in neutropenic patients based on clinical criteria and risk factors, and with a diagnostic approach, rather than general treatment.

Cancer is one of the most important diseases of current century and the second cause of death after cardiovascular diseases. Various factors are effective in the occurrence of malignancy and one of the most important factors is blood infection. The present study was aimed to investigating the frequency of clinical and paraclinical indicators of cancer patients with symptoms of sepsis. This cross-sectional study, 100 cancer patients' referred to the emergency department of Imam Khomeini Hospital in Sari city with signs of sepsis were selected. Finally, the information obtained from the questionnaires was entered into SPSS-18 software and the collected information was statistically analyzed using descriptive statistics (prevalence and mean) and T-test. Among the patients, 57% were men and 43% were women. 56% had sepsis, 42% had severe sepsis and only 2% had septic shock. Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter and Candida albicans (C. albicans) were the most prevalent causes of sepsis. Blood pressure in most patients is lower than normal and 26% of patients have a history of diabetes. The highest frequency of cancer was related to stomach and small intestine cancer, and neutropenia was present in all types of cancer except leukemia and lymphoma. The results of this study showed that many non-specific parameters for cancer diagnosis should be taken into consideration by emergency department specialist and should not be easily interpreted from symptoms such as fever, diabetes, decrease or increase in neutrophils and white blood cells. Forgiveness.

Disseminated fusariosis is an opportunistic infection caused by the hyaline fungus Fusarium spp. and occurs mainly in patients with leukemia.

Two cases of disseminated fusariosis in pediatric patients are presented.Profound and prolonged neutropenia, fever, myalgia, and skin lesions in the legs werepresent in two girls with leukemia undergoing chemotherapy. In the first case, infectionby Fusarium spp. was confirmed by anatomopathological findings, pathogen isolation, and polymerase chain reaction. In the second case, Fusarium solani infection was confirmed by mass spectrometry using blood cultures and skin lesion samples.

It is important to consider disseminated fusariosis in high-risk patients who present with profound and prolonged neutropenia and persistent fever that does not resolve after broad-spectrum antibiotics to initiate antifungal therapy in a timely manner.

The most prominent part of the cellular response of the immune system is driven by neutrophils. These cells tend to decline following chemotherapy in patients with leukemia. Neutropenia is an influential factor in the prognosis of cancer patients. Stress reduces white blood cells (WBCs) and neutrophils are linked to an increased risk of infectious diseases after chemotherapy. We investigated the association between neutropenia and perceived stress following chemotherapy.

We performed a cross-sectional study on 60 patients with leukemia in a university hospital. Participants completed self-report measures, including the demographic data and perceived stress scale (PSS) questionnaire. We compared rates of neutropenia, as a measure of chemotherapy prognosis, 10 days after chemotherapy in different stress levels. Moreover, the number of patients with polymorphonuclear (PMN) under 1000/microliter was compared at different stress levels.

We found that neutropenia is directly correlated with negative stress perception and inversely correlated with positive stress perception. These effects appear more prominent in patients with PMN under 1000/microliter as the number of these patients was significantly more in groups with higher negative stress and less in groups with higher positive stress scores.

It can be concluded that stress is correlated with neutropenia, and stress management in patients with leukemia will be accompanied by better recovery outcomes and reduced risk of infectious disease.

Autoimmune neutropenia is a type of immune-mediated neutropenia, caused by antibody-induced neutrophil destruction. Here, we report two cases (a 3-year-old boy and a 9-year-old girl) with suspected autoimmune neutropenia. The presence of neutrophil antibodies in the sera of these two patients was investigated; using standard neutrophil antibody screening tests such as granulocyte immunofluorescence test (GIFT), granulocyte agglutination test (GAT), and lymphocyte immunofluorescence test (LIFT). A positive reactivity with two-panel cells was found in GIFT. No reactivities with panel cells were observed in GAT and LIFT. To the best of our knowledge, this is the first report for detecting the neutrophil reactive antibodies; using genotyped neutrophils in patients with autoimmune neutropenia in Iran. The final diagnosis of our patients was primary autoimmune neutropenia for the boy and autoimmune neutropenia associated with familial Mediterranean fever for the girl.

X-Linked Agammaglobulinemia (XLA) is a primary immunodeficiency disease, characterized by severe hypogammaglobulinemia and the low numbers of peripheral B cells. Neutropenia is a rare complication among the XLA patients, which may lead to a higher rate of infections and morbidity. The aim of the authors is to assess the correctness of this issue.

In this study, we compared demographic, clinical and laboratorial data between two groups of XLA patients, with and without neutropenia.

Frequency of neutropenia was 15% in our population. Infectious complications were the most prevalent clinical manifestations, regardless of the presence of neutropenia. However, Lymphoproliferative complication was significantly higher in the neutropenic patients (p = 0.001). No significant difference in mortality rate was observed between the groups.

Neutropenia is a rare complication among the XLA patients, and significantly decreases the mean age of XLA diagnosis in the patients. But it is not related to the higher frequency of infectious diseases in the neutropenic patients compared to non-neutropenic ones.

Chemotherapy‐induced neutropenia is one of the risk factors for infection in patients undergoing chemotherapy (due to weakened immune system). Febrile neutropenia (FN) may be the sole indicator of an underlying infection in these patients. Since infection is associated with an increased risk of mortality in patients undergoing chemotherapy, the study aimed to assess the incidence of FN in neutropenic cancer patients admitted to the oncology ward.

This was a descriptive, cross-sectional study involving 52 patients (selected using census method) with signs of infection (FN) hospitalized in Ghazi Tabatabai Hospital (Tabriz University of Medical Sciences) in 2018-20. The participants consisted of 52 neutropenic cancer patients who developed FN and were admitted to the oncology ward of Ghazi Tabatabai Hospital in 2018-20. Collected data was written down in specific forms and analyzed using descriptive (frequency, percentage, and mean) and inferential statistics with SPSS v.20. Significance level was less than 0.05.

Absolute neutrophil count (ANC) was less than 500 cells/ml in 15.38% of the patients (8 patients). Infection was the cause of FN in 69.23% of the patients (36 patients). An unknown factor was the cause of infection in 30.77% of the cases. The incidence of all types of infections (perianal abscess, sepsis, oral infection, cutaneous infection, gastrointestinal infection, pharyngitis, pneumonia, and urinary tract infection) was higher in patients undergoing chemotherapy than those not receiving  chemotherapy.

Infection is one of the main causes of FN in cancer patients admitted to the oncology ward.