A 7-month old girl developed fever to 38.9C

with cough, rhinorrhea, and loose stools


پروفسور محمد حسین سلطان زاده

      استاد دانشگاه علوم پزشکی شهید بهشتی
     متخصص کودکان ونوزادان
        طی دوره بالینی عفونی از میوکلینیک آمریکا
دبیر برگزاری کنفرانس های ماهیانه گروه اطفال
 دانشگاه علوم پزشکی شهید بهشتی




Discussion, Dif. Diagnosis

  Neutropenia, defined as an :

 Absolute decrease in the number of circulating neutrophils in the blood can caused by :

Decreased production

 Increased peripheral utilization

Increased destruction

The ANC is calculated by :

 ANC = total WBC X  ( percent Bands+ percent segmented neutrophils )

Patient may be characterized:

 Mild ; 1000-1500 cells mm3

 Moderate ; 500-1000 cells mm3

 Severe ; fewer than 500 cells mm3



 Alloimmune NeonataL Neutropenia

 Cyclic neutropenia

 Autoimmune Neutropenia (AIN) in infancy

 Kostman Synd.

 Neutropenia related Infection

 Neutropenia with increased peripheral utilization in serious cellulitis

 Epstein- Barr virus & parovirus B19


 B.M. aspiration revealed :

 Hypercellular Marrow

Increased number of Granulocytes with maturation to the band stage

 No mature Neutrophils

 Immunogloboline Normal

 Diagnosis  :

 These findings combined with the Neutropenia suggest the diagnosis of Autoimmune Neutropenia of Infancy