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Efficacy of Prophylactic Use of Trimethoprim–Sulfamethoxazole in Autoimmune Neutropenia in Infancy

Kobayashi, Masao MD; Sato, Takashi MD; Kawaguchi, Hiroshi MD; Nakamura, Kazuhiro MD; Kihara, Hirotaka MD; Hiraoka, Asako; Tanihiro, Misae; Taniguchi, Kikuyo; Takata, Noboru MD; Ueda, Kazuhiro MD

Journal of Pediatric Hematology/Oncology: July 2003 - Volume 25 - Issue 7 - p 553-557

Purpose Most children with autoimmune neutropenia (AIN) have a benign clinical course because of the spontaneous resolution of neutropenia. The authors observed the clinical course of AIN in infancy accompanied by the prophylactic use of trimethoprim–sulfamethoxazole (TMP-SMX) during neutropenia.

Patients and Methods Eight infants with AIN were followed by serial tests for antineutrophil antibodies and management of infectious complications.

Results The spontaneous disappearance of antineutrophil antibodies that preceded the normalization of the neutrophil count was found in all patients. Until the resolution of neutropenia, TMP-SMX was administered in five patients, resulting in a reduction in the incidence of infection with no adverse effects.

Conclusions These observations demonstrate the possibility of the safety and usefulness of TMP-SMX treatment in patients with AIN.

From the Department of Child Health, Hiroshima University Graduate School of Education, Higashi-Hiroshima, Japan (M.K.), Department of Pediatrics, Hiroshima University School of Medicine, Hiroshima, Japan (M.K., T.S., H.K., K.N., H.K., K.U.), and Division of Transfusion, Hiroshima University Hospital, Hiroshima University School of Medicine, Hiroshima, Japan (A.H., M.T., K.T., N.T.).

Submitted for publication December 12, 2002; accepted March 14, 2003.

Supported in part by Grants-in-Aid (to M.K. and K.U.) for Scientific Research (C) from the Ministry of Education, Science, Sports and Culture of Japan.

Address correspondence and reprint requests to Masao Kobayashi, MD, Department of Child Health, Hiroshima University Graduate School of Education, 1-1-1 Kagamiyama Higashi-Hiroshima, Hiroshima, 739-8524 Japan. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.