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Pediatrics Conference 2018
Journal of Pediatric Care
ISSN: 2471-805X
Page 20
March 26-27, 2018
Edinburgh, Scotland
2
nd
Edition of International Congress on
Pediatrics
Objective:
Chronic neutropenia of childhood (CNC) is a rare
disorder in which the absolute neutrophil count is below
1500/L over an extended period of time. The objective of
this study is to describe the otolaryngologic manifestations
associated with CNC to facilitate diagnosis and treatment of
this condition.
Methods & Materials:
We performed a retrospective chart
review of patients with the diagnosis of CNC between
1970 and 2005 at a tertiary pediatric hematology center.
After Institutional Review Board approval, 43 patients were
evaluated. The average age at hematologic diagnosis was
49 months (range: 1 month – 15 years with 35% <1 year, 44%
1–10 years, 21% >10 years). A total of 2049 encounters were
analyzed from the hospital charts.
Results:
Twenty four subjects (56%) presented with recurrent
otitis media (ROM), sinusitis or pharyngotonsillitis, while
11% presented with oral mucosal lesions. After diagnosis,
otolaryngologic problems persisted, including ROM (81%),
viral upper respiratory tract infection (67%), oral ulcers or
gingivitis (53%), tonsillitis (39%) and sinusitis (37%) and were
more common than other systemic infections. Myringotomy
tube placement, endoscopic sinus debridement, adeno-
tonsillectomy or tracheostomy were required in 42% of
patients. After G-CSF (granulocyte colony-stimulating factor)
became available in the early 1990s, the infection rate markedly
decreased. Five deaths occurred (12% mortality) including one
due to sepsis from otolaryngologic infection.
Conclusion:
The majority of children with CNC had
otolaryngologic problems at presentation and these continued
after diagnosis. While managing common otolaryngologic
infections in children, a high index of suspicion for chronic
neutropenia is necessary. An otolaryngologist is frequently one
of the first physicians to encounter children with this condition.
Awareness of CNC and its management will enhance earlier
diagnosis and more effective treatment for these children.
Biography
Rose Mary S Stocks is the Residency Program Director for Otolaryngology,
Head & Neck Surgery Department at UTHSC. She is a fellowship trained Pe-
diatric Otolaryngologist with a Doctorate in Pharmacy and a long bench re-
search history. She has conducted numerous NIH-funded research endeav-
ors with an emphasis on ototoxicity and its prevention in the administration
of chemotherapy in the guinea pig model. She has participated in, and pub-
lished her experience in extra-uterine, prenatal surgical repair of defects of
the head and neck (the EXIT procedure). She has served as Research Men-
tor to numerous residents over the years and greatly increased the amount
of scholarly activity within the department. She has taught courses at a na-
tional level for the American Academy of Otolaryngology, Head and Neck
Surgery on Down’s Syndrome for the Otolaryngologist and Management of
the Difficult Pediatric Airway. She teaches first year medical students about
examination of the ear, nose, and throat and is a tireless surgical educator
in the training program. She is a Member of the LeBonheur Multidisciplinary
Cleft Lip and Palate Team and devotes her expertise to the care of these
patients and their families.
rstocks@uthsc.eduChronic neutropenia of childhood
Rose Mary S Stocks
University of Tennessee Health Science Center, USA
Rose Mary S Stocks, J Pediatr Care, Volume 4
DOI: 10.21767/2471-805X-C1-005