A low absolute neutrophil count can occur in a neonate for a number of reasons.


The diagnosis of neutropenia should be based on the absolute neutrophil count relative to a reference range based on age, gender and race.


Common causes:

(1) sepsis or other bacterial infection

(2) maternal hypertension

(3) neonatal alloimmune neutropenia (NAIN)

(4) congenital viral infection

(5) prematurity (reduced production)


Less common causes:

(1) Kostmann Syndrome (infantile genetic agranulocytosis)

(2) other congenital neutropenia

(3) twin-twin transfusion

(4) drug-induced

(5) neonatal leukemia


Differential diagnosis:

(1) artifact due to sample collection or handling

(2) racial variation (Black lower than White)


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