{
  "abstract": "Background Autoimmune neutropenia (AIN) is the main cause of chronic neutropenia in children, but its infectious consequences remain poorly studied. The primary objective of this study was to evaluate infectious events leading to emergency department or hospital admissions during the first 2 years following the diagnosis of AIN in children.Methods We performed a retrospective, multicentre analysis of medical records from 21 French university hospitals of patients aged under 18 years diagnosed with AIN with positive antineutrophils autoantibodies. We collected data on emergency room visits and hospitalisations in the 2 years following diagnosis, causes of these events, microbiology results, management and outcome.Results One hundred and sixty-eight patients were enrolled. Median age at diagnosis of AIN was 13 months. AIN was predominantly diagnosed during an infectious episode (n=120, 71%). In the 2 years of follow-up after diagnosis, 248 events of emergency room visits and/or hospitalisations were reported (0.77 per patient-year). The most frequent diagnoses were common childhood viral or bacterial infections. The incidence rate of severe infections was 0.003 per patient-year. Despite the predominance of viral infections, 177 episodes (71%) led to hospitalisation and 166 (68%) to the initiation of antibiotic therapy, for a median duration of 7 days (IQR 3–10).Conclusion The risk of severe infections in children with AIN is low. During follow-up, we suggest being attentive to signs of severity during fever, particularly in children over 3 years of age and/or with other immunological comorbidities but not proposing systematic hospitalisation or additional antibiotic therapy.",
  "authors": [
    {
      "affiliations": [
        "Infectious Diseases and Tropical Medicine, Angers University Hospital, Angers, France"
      ],
      "name": "Robin Dhersin"
    },
    {
      "affiliations": [
        "Oncology, Hematology, Immunology Pediatric Unit, Angers University Hospital, Angers, France"
      ],
      "name": "Estelle Trebucq"
    },
    {
      "affiliations": [
        "Immunology Biology, University Hospital Centre Nantes, Nantes, France"
      ],
      "name": "Marie Rimbert"
    },
    {
      "affiliations": [
        "Pediatric Oncology and Hematology Department, CHU Caen, Caen, France"
      ],
      "name": "Jérémie Rouger-Gaudichon"
    },
    {
      "affiliations": [
        "Pediatric Department, University Hospital Centre Dijon General Hospital, Dijon, France"
      ],
      "name": "Florent Neumann"
    },
    {
      "affiliations": [
        "Department of Pediatric Oncology, Nancy University Hospital Center, Nancy, France"
      ],
      "name": "Pascal Chastagner"
    },
    {
      "affiliations": [
        "Department of Paediatric Oncology, University Hospital Centre Reims, Reims, France"
      ],
      "name": "Grégory Guimard"
    },
    {
      "affiliations": [
        "Pédiatrie générale multidisciplinaire, CHU Grenoble, Grenoble, France"
      ],
      "name": "Dominique Plantaz"
    },
    {
      "affiliations": [
        "Department of Pediatric Onco-Immuno-Hematology, CHU Grenoble Alpes, Grenoble, France"
      ],
      "name": "Sandrine Billet"
    },
    {
      "affiliations": [
        "Pediatric Hematology Department, Lille University Hospital, Lille, France"
      ],
      "name": "Wadih Abouchahla"
    },
    {
      "affiliations": [
        "Pediatric Haematology Department, Timone Enfant, APHM, Marseille, France"
      ],
      "name": "Audrey Petit"
    },
    {
      "affiliations": [
        "Pédiatrie générale, CHRU Montpellier, Montpellier, France"
      ],
      "name": "Eric Jeziorski"
    },
    {
      "affiliations": [
        "Department of Paediatric Haematology/Oncology, Amiens-Picardy University Hospital, Amiens, France"
      ],
      "name": "Valérie Li Thiao Te"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Centre Hospitalier Universitaire de Besancon, Besançon, France"
      ],
      "name": "Nathalie Cheikh"
    },
    {
      "affiliations": [
        "Pediatric Department",
        "Centre de Référence National des Cytopénies Auto-immunes de l’Enfant (CEREVANCE), University Hospital Centre Bordeaux, Talence, France"
      ],
      "name": "Nathalie Aladjidi"
    },
    {
      "affiliations": [
        "Department of Pediatric Hematology-Oncology, Brest University Hospital Centre, Brest, France"
      ],
      "name": "Liana Carausu"
    },
    {
      "affiliations": [
        "Pediatric Hematology, Centre Hospitalier Universitaire de Nantes, Nantes, France"
      ],
      "name": "Caroline Thomas"
    },
    {
      "affiliations": [
        "Department of Hemato-Oncology Pediatric, University Hospital Centre Nantes, Nantes, France"
      ],
      "name": "Audrey Grain"
    },
    {
      "affiliations": [
        "University Hospital Centre Nice, Nice, France"
      ],
      "name": "Joy Benadiba"
    },
    {
      "affiliations": [
        "Paediatric Haematology-Oncology Unit, University Hospital Centre Poitiers, Poitiers, France"
      ],
      "name": "Laurence Blanc"
    },
    {
      "affiliations": [
        "Department of Hemato-Oncology Pediatric, Rennes University Hospital, Rennes, France"
      ],
      "name": "Elie Cousin"
    },
    {
      "affiliations": [
        "Pediatric Immuno-Hematology-Oncology Unit, University Hospital Centre Rouen Charles-Nicolle Site, Rouen, France"
      ],
      "name": "Aude Marie-Cardine"
    },
    {
      "affiliations": [
        "Department of Pediatric Immunology, Hematology and Rheumatology, Necker-Enfants Malades Hospitals, Paris, France",
        "Laboratory of Genome Dynamics in the Immune System, Equipe Labellisée Ligue, INSERM UMR, Imagine Institute, INSERM, Paris, France"
      ],
      "name": "Despina Moshous"
    },
    {
      "affiliations": [
        "Department of Hemato-Oncology Pediatric, Toulouse III University-Paul Sabatier Purpan Faculty of Medicine, Toulouse, France"
      ],
      "name": "Marlène Pasquet"
    },
    {
      "affiliations": [
        "Department of Pediatric Hematology-Oncology, Hôpital Gatien de Clocheville, Tours, France"
      ],
      "name": "Julien Lejeune"
    },
    {
      "affiliations": [
        "Department of Pediatric Immuno-Hematology, Robert-Debré Mother-Child University Hospital, Paris, France"
      ],
      "name": "Saba Azarnoush"
    },
    {
      "affiliations": [
        "Centre de référence des neutropénies chroniques, Registre des neutropénies chroniques, Armand-Trousseau Hospital, Paris, France"
      ],
      "name": "Blandine Beaupain"
    },
    {
      "affiliations": [
        "Infectious Diseases and Tropical Medicine, Angers University Hospital, Angers, France",
        "Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France, INSERM Délégation Régionale Grand Ouest, Nantes, France"
      ],
      "name": "Vincent Dubée"
    },
    {
      "affiliations": [
        "Oncology, Hematology, Immunology Pediatric Unit, Angers University Hospital, Angers, France",
        "Université d’Angers, Université de Nantes, Inserm, CNRS, CRCI2NA, SFR ICAT, INSERM Délégation Régionale Grand Ouest, Nantes, France"
      ],
      "name": "Isabelle Pellier"
    },
    {
      "affiliations": [
        "Centre de référence des neutropénies chroniques, Registre des neutropénies chroniques, Armand-Trousseau Hospital, Paris, France",
        "Service d’Hémato-Oncologie Pédiatrique, Armand-Trousseau Hospital, Paris, France"
      ],
      "name": "Jean Donadieu"
    },
    {
      "affiliations": [
        "Oncology, Hematology, Immunology Pediatric Unit, Angers University Hospital, Angers, France",
        "Université d’Angers, Université de Nantes, Inserm, CNRS, CRCI2NA, SFR ICAT, INSERM Délégation Régionale Grand Ouest, Nantes, France"
      ],
      "name": "Coralie Mallebranche"
    }
  ],
  "title": "Analysis of infectious complications in paediatric autoimmune neutropenia: a French nationwide retrospective cohort study",
  "uid": "02968891-98ba-5780-8614-32a5cc9a500c"
}