Etiologies of neutropenia by mechanism and age
| . | Neonates . | Infants/children . | Adolescents and young adults . | Adults . |
|---|---|---|---|---|
| Decreased bone marrow reserve | ||||
| Intrinsic defects in myelopoiesis | - Inborn errors of myelopoiesis (eg, ELANE-related neutropenia) | - Inborn errors of myelopoiesis (eg, SDS, ELANE-related neutropenia, GATA2 haploinsufficiency) | - Inborn errors of myelopoiesis (eg, GATA2 haploinsufficiency, BMF syndromes) | - Acquired MDS - Inborn errors of myelopoiesis (eg, GATA2 haploinsufficiency) |
| Extrinsic limitations on myelopoiesis | - Maternal hypertension - Prematurity - Viral infection - Infiltration of the marrow space (eg, neuroblastoma, osteopetrosis) | - Viral infection - Nutritional deficiencies - Medications - Infiltration of the marrow space (eg, acute leukemia) | - Viral infection - Medications - Idiopathic aplastic anemia - Nutritional deficiencies (eg, anorexia nervosa) - Drug abuse - Alcoholism | - Medications - Viral infection - Nutritional deficiencies (eg, vitamin B12 deficiency, copper deficiency) - Idiopathic aplastic anemia - Infiltration of the marrow space (eg, T-LGL, fibrosis, myeloma) - Thymoma with pure WBC aplasia - Drug abuse - Alcoholism |
| Normal bone marrow reserve | ||||
| Ineffective trafficking | - Inborn errors of immunity (eg, WHIM syndrome) | - Inborn errors of immunity (eg, WHIM syndrome) | - Inborn errors of immunity (eg, WHIM syndrome) - Hypersplenism | - Hypersplenism |
| Immune-mediated destruction | - Postinfectious antibody-mediated neutropenia - Isoimmune neutropenia - Alloimmune neutropenia | - Postinfectious antibody-mediated neutropenia - Autoimmune neutropenia of infancy - Drug-related antibody-mediated neutropenia | - Postinfectious antibody- mediated neutropenia - Drug-related antibody- mediated neutropenia - Primary autoimmune neutropenia - Autoimmune neutropenia associated with inborn errors of immunity | - Drug-related antibody-mediated neutropenia - Postinfectious antibody-mediated neutropenia - Autoimmune neutropenia associated with autoimmune disorders - Primary autoimmune neutropenia - Cytokine-induced apoptosis (eg, chronic idiopathic neutropenia) |
| Increased consumption | - Neonatal sepsis | - Bacterial infection | - Bacterial infection | - Bacterial infection |
| . | Neonates . | Infants/children . | Adolescents and young adults . | Adults . |
|---|---|---|---|---|
| Decreased bone marrow reserve | ||||
| Intrinsic defects in myelopoiesis | - Inborn errors of myelopoiesis (eg, ELANE-related neutropenia) | - Inborn errors of myelopoiesis (eg, SDS, ELANE-related neutropenia, GATA2 haploinsufficiency) | - Inborn errors of myelopoiesis (eg, GATA2 haploinsufficiency, BMF syndromes) | - Acquired MDS - Inborn errors of myelopoiesis (eg, GATA2 haploinsufficiency) |
| Extrinsic limitations on myelopoiesis | - Maternal hypertension - Prematurity - Viral infection - Infiltration of the marrow space (eg, neuroblastoma, osteopetrosis) | - Viral infection - Nutritional deficiencies - Medications - Infiltration of the marrow space (eg, acute leukemia) | - Viral infection - Medications - Idiopathic aplastic anemia - Nutritional deficiencies (eg, anorexia nervosa) - Drug abuse - Alcoholism | - Medications - Viral infection - Nutritional deficiencies (eg, vitamin B12 deficiency, copper deficiency) - Idiopathic aplastic anemia - Infiltration of the marrow space (eg, T-LGL, fibrosis, myeloma) - Thymoma with pure WBC aplasia - Drug abuse - Alcoholism |
| Normal bone marrow reserve | ||||
| Ineffective trafficking | - Inborn errors of immunity (eg, WHIM syndrome) | - Inborn errors of immunity (eg, WHIM syndrome) | - Inborn errors of immunity (eg, WHIM syndrome) - Hypersplenism | - Hypersplenism |
| Immune-mediated destruction | - Postinfectious antibody-mediated neutropenia - Isoimmune neutropenia - Alloimmune neutropenia | - Postinfectious antibody-mediated neutropenia - Autoimmune neutropenia of infancy - Drug-related antibody-mediated neutropenia | - Postinfectious antibody- mediated neutropenia - Drug-related antibody- mediated neutropenia - Primary autoimmune neutropenia - Autoimmune neutropenia associated with inborn errors of immunity | - Drug-related antibody-mediated neutropenia - Postinfectious antibody-mediated neutropenia - Autoimmune neutropenia associated with autoimmune disorders - Primary autoimmune neutropenia - Cytokine-induced apoptosis (eg, chronic idiopathic neutropenia) |
| Increased consumption | - Neonatal sepsis | - Bacterial infection | - Bacterial infection | - Bacterial infection |
WBC, white blood cell.