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Identifier 000441429
Title Λευκοπενία – λεμφοκυττάρωση σε παιδιά και εφήβους : Πορεία – πρόγνωση παραπομπών σε Παιδοαιματολογική Κλινική
Alternative Title Leucopenia with lymphocytosis in childhood and adolescence
Author Αθανασόπουλος, Εμμανουήλ
Thesis advisor Στειακάκη, Ευτυχία
Reviewer Παπαδάκη, Ελένη
Ποντίκογλου, Χαράλαμπος
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.
Language Greek
Subject Prognosis
Underlinr causes
Work up
Issue date 2021-07-29
Collection   School/Department
  Type of Work--Post-graduate theses
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