| Abstract |
Introduction: Lymphocytosis refers to an increase in the number of lymphocytes in the blood.
Absolute lymphocytosis is characterized by an increase in the lymphocyte count above the
normal range; in children older than 12 years above the 4000/μL threshold and in younger
children above 8000/μL. Relative lymphocytosis refers to an increase in the lymphocyte
proportion relative to the white blood cell count. Lymphocytosis constitutes a common finding
in children and adolescents. In the majority of cases, an underlying cause cannot be identified,
and the condition is self-resolving, while less often, especially when associated with leukopenia
and neutropenia, further investigation is warranted.
The aim of our study is to investigate the epidemiological, clinical and laboratory characteristics
of children and adolescents that have been evaluated in a tertiary hospital with lymphocytosis
in a 5-year period.
Patients and Methods: A retrospective cohort study was performed and demographic, clinical
and laboratory data were collected from children and adolescents that were referred to the
outpatient services of the Paediatric Haematology – Oncology Department of the University
Hospital of Crete due to lymphocytosis. Statistical analysis was conducted using Graph Pad
Prism version 9.1.2 ©. statistical software. Mann-Whitney test was used to compare categorical
variables while continuous variables were compared by Fisher’s exact test. The odds ratios
(OR) were calculated and a p value <0.05 was considered statistical significant. Results: A total of 103 patients with lymphocytosis were included in the study; 47 girls and 56
boys. The age range at diagnosis was 6.06 to 17.35 years old (mean 10.87 years). In 83.65% of
cases no underlying cause was identified. Causes of lymphocytosis included: hypothyroidism
in 7.77% of cases, viral infections (0.97% Epstein – Barr virus, 0.97% Mumps, 0.97%
Adenovirus) and antiepileptic treatment (1.94% Valproic Acid, 0.97% Levetiracetam). One
case was attributed to autoimmune condition and one case to Myelodysplastic syndrome. In
most of the cases (73.79%), the lymphocytosis resolved within 16.14 months from the time of
diagnosis. In addition, 41.75% had recovered on the first visit. Patients with lymphocytosis due
to an underlying cause versus those without cause differed significantly in terms of white blood
cell count (p value 0.01), mean absolute neutrophil count, (p value 0.006) and the mean absolute
lymphocyte count, (p value 0.01). Also, patients whose lymphocytosis resolved versus those
whose lymphocytosis remained differed significant in terms of older age at diagnosis and
presence of relative lymphocytosis (p value 0.04 and p 0.008 respectively).
Conclusions: In agreement with the existing literature, lymphocytosis in healthy children is
often a self-resolving condition with good prognosis. Underlying causes are identified rarely
and include endocrine, autoimmune, hematological conditions, viral infections and drugs. Low
white blood cell count, low neutrophil and low lymphocyte count at diagnosis are more
commonly associated with an underlying cause while older age at diagnosis and the presence
of relative lymphocytosis are associated with full recovery.
|
Λευκοπενία – λεμφοκυττάρωση σε παιδιά και εφήβους : Πορεία – πρόγνωση παραπομπών σε Παιδοαιματολογική Κλινική
