Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited

Journal of Perinatology : Official Journal of the California Perinatal Association
N SchmutzRobert D Christensen

Abstract

Upper and lower reference limits for blood neutrophil concentrations of neonates were reported by Manroe, Rosenfeld and co-workers in 1979 and by Mouzinho, Rosenfeld and co-workers in 1994. Studies by Carballo and co-workers and Maynard and co-workers suggested that at high altitude a much higher upper limit of values occurs, and that neutrophilia is often diagnosed inappropriately, at high altitude, if the Manroe and Mouzinho charts are used. We revisited the Manroe and Mouzinho charts using modern cell counting instrumentation and very large sample sizes. This was accomplished with data from an 18-hospital health-care system, at hospitals averaging 4,800 feet above sea level. Data were obtained from neonates in the first 10 days following birth, using tests performed on a single type of automated blood cell counter (Beckman Coulter LH 750, Fullerton, CA, USA). To obtain a description of 'expected values,' patients with the following diagnoses, known to have a high proportion of abnormal neutrophil counts, were excluded from the analysis; (1) maternal pregnancy-induced hypertension, (2) early-onset bacterial sepsis, (3) a discharge diagnosis of congenital neutropenia and (4) trisomy 21, 18 or 13. Blood neutrophil concentration...Continue Reading

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