Transient Neonatal Neutropenia -- Important Criteria to Keep in Mind

The assignment of P61.5, Transient neonatal neutropenia has been audited at increasing rates by payors. “Transient neonatal neutropenia” is not a single clinical entity but represents a differentiation between the very rare persistent congenital neutropenic syndromes and a transient phenomenon. Neutropenia in neonates is not considered “persistent” until greater than 5-7 days

Definition of neutropenia in the neonate

ANC < 2SD below the mean or <5th percentile for postnatal age.

ANC < 1000 cells/mm3

Risk factors/Etiologies by Category

Decreased Neutrophil Production:

Small for gestational age (previously thought pre-eclampsia in the mother, but correlated with SGA) Neonates with Rh hemolytic disease (bone marrow production shifts toward erythrocyte precursors)

Increased Neutrophil Destruction:

Necrotizing enterocolitis Drug-Induced Neutropenia:

Viral Infections:

Other:

Congenital Neutropenias / Bone Marrow Failure Syndromes – persistent and not subtle

Inborn Errors of Metabolism