Neutropenia is Less Frequent in Patients than in General Population: A Benign (Ethnic) Neutropenia Study


  •   Srdjan Denic

  •   Sami Shaban

  •   Hassib Narchi

  •   Abdul-Kader Souid


Background: Benign (ethnic) neutropenia (BN) is an inherited condition, common in many parts of the world, and often undiagnosed. It should be differentiated from other types of neutropenia which increase the risk of infections.

Objective: We aimed to ascertain the frequency of neutropenia in patients from a population (citizens of the United Arab Emirates) with a known high frequency of BN (10.7%) to assess how often clinicians might be compelled to differentiate benign neutropenia from other types of neutropenia.

Methodology: Study subjects were 27,392 Emirati inpatients and outpatients of all ages in a general hospital. They had 55,935 absolute neutrophil counts (ANC). Patients were defined to have neutropenia if the ANC was <1.5x109/L. The frequency of neutropenia was analyzed against several relevant variables.

Results: Among patients who had one test, the overall frequency of neutropenia (5.3%) was half that in a healthy population (10.7%) in earlier study (p < 0.0001). The prevalence of neutropenia was lower in hospitalized (3.5%, 132/3,769) than in non-hospitalized (9.2%, 510/5,570) patients (p<0.0001), where it was similar (p=0.13) to that in the general population (10.7%, 110/1032). While none of the 282 pregnant women at the time of delivery had neutropenia, it was most common among pediatric outpatients (15.1%, 75/497). Neutropenia was more frequent in patients who had more ANC determinations: one test, 5.3%; two tests, 7.8%; three and more tests, 12.4% (p<0.00001).

Keywords: Public health practice, Ethnicity, Disease frequency surveys, Screening, Common inherited blood disorders


Haddy TB, Rana SR, Castro O. Benign ethnic neutropenia: What is a normal absolute neutrophil count? J Lab Clin Med. 1999; 133:15–22.

Shoenfeld Y, Alkan ML, Asaly A, Carmell Y, Katz M. Benign familial leucopenia and neutropenia in different ethnic groups. Eur J Haematol. 1988; 41:273–7.

Denic S, Showqi S, Klein C, Takala M, Nagelkerke N, Agarwal MM. Prevalence, phenotype and inheritance of benign neutropenia in Arabs. BMC Blood Disord. 2009; 9:3.

Grann VR, Ziv E, Joseph CK, Neugut AI, Wei Y, Jacobson JS, et al. Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean. Br J Haemat. 2008; 143:288–93.

Nalls MA, Wilson JG, Patterson NJ, Tandon A, Zmuda JM, Huntsman S, Garcia M, Hu D, Li R, Beamer BA, Patel KV, Akylbekova EL, Files JC, Hardy CL, Buxbaum SG, Taylor HA, Reich D, Harris TB, Ziv E. Admixture mapping of white cell count: genetic locus responsible for lower white blood cell count in the Health ABC and Jackson Heart studies. Am J Hum Genet. 2008; 82(1):81-7.

Rappoport N, Simon AJ, Lev A, Yacobi M, Kaplinsky C, Weingarten M, Somech R, Amariglio N, Rechavi G. Correlation between 'ACKR1/DARC null' polymorphism and benign neutropenia in Yemenite Jews. Br J Haematol. 2015;170(6):892-5.

Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP. Prevalence of neutropenia in the U.S. population: Age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007; 146:486–92.

Denic S, Narchi H, Al Mekaini LA, Al-Hammadi S, Al Jabri ON, Souid AK. Prevalence of neutropenia in children by nationality. BMC Hematol. 2016; 16:15.

Howells DP. Neutropenia in people of African origin. Lancet 1971; 2:1318–9.

Jumean HG, Sudah FI. Chronic benign idiopathic neutropenia in Jordanians. Acta Haemat. 1983; 69:59–60.

Weingarten MA, Pottick-Schwartz EA, Brauner A. The epidemiology of benign leucopenia in Yemenite Jews. Isr J Med Sci. 1993; 29:297–9.

Kaab SA, Fadhli SA, Burhamah M, Al Jafar H, Khamis A. Lymphocyte subsets in healthy adult Kuwaiti Arabs with relative benign ethnic neutropenia. Immunol Lett. 2004; 91:49–53.

Denic S, Nicholls MG. A call for screening for benign neutropenia in Arab populations. Saudi Med J. 2011; 32:738–9.

Bejjani N, Beaupain B, Bertrand Y, Bellanne-Chantelot C, Donadieu J. How to differentiate congenital from noncongenital chronic neutropenia at the first medical examination? Proposal of score: A pilot study from the French Severe Chronic Neutropenia registry. Pediatr Blood Cancer. 2017; 64(12).

Mason BA, Lessin L, Schechter GP. Marrow granulocyte reserves in black Americans. Hydrocortisone-induced granulocytosis in the "benign" neutropenia of the black. Am J Med. 1979;67(2):201–5.

Deinard AS, Page AR. A study of steroid-induced granulocytosis in a patient with chronic benign neutropenia of childhood. Br J Haematol. 1974; 28(3):333-45.

Baldwin C, Roath S.The evaluation of neutropenia: the use of the granulocyte mobilization test. Clin Lab Haematol. 1983; 5(4):353-60.

Lurie S, Rahamim E, Piper I, Golan A, Sadan O. Total and differential leukocyte counts percentiles in normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2008; 136(1):16-9.

Phillips D, Rezvani K, Bain BJ. Exercise induced mobilisation of the marginated granulocyte pool in the investigation of ethnic neutropenia. J Clin Pathol. 2000; 53(6):481-3.

Shoenfeld Y, Modan M, Berliner S, et al. The mechanism of benign hereditary neutropenia. Arch Intern Med. 1982; 142(4):797-9.

Shoenfeld Y, Aloni D, Keren G,et al. Effect of physical effort on the white blood cells in benign familial leucopenia. Acta Haemat. 1981; 65:108-13.

Shoenfeld Y, Shindel D, Neri A, Berliner S, Lusky A, Kaufman C, Pinkhas J. Pregnancy-induced leukocytosis in Yemenite Jews. Acta Haematol. 1983; 70(3):170-4.

al-Gazali LI, Bener A, Abdulrazzaq YM, Micallef R, al-Khayat AI, Gaber T. Consanguineous marriages in the United Arab Emirates. J Biosoc Sci. 1997; 29(4):491-7.

Bittles AH,Black ML. Global Patterns & Tables of Consanguinity. 2015 Accessed 3 Feb 2019.

Ancliff PJ. Congenital neutropenia. Blood Rev. 2003;17(4):209-16.

Kelly DL, Kreyenbuhl J, Dixon L, et al. Clozapine underutilization and discontinuation in African Americans due to leucopenia. Schizophr Bull. 2007; 33:1221–4.

Kuno E, Rothbard AB. Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiatry. 2002; 159:567–72.

U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA modifies monitoring for neutropenia associated with schizophrenia medicine clozapine; approves new shared REMS program for all clozapine medicines. 2015. Accessed 4 Nov 2018.


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How to Cite
Denic, S., Shaban, S., Narchi, H., & Souid, A.-K. (2020). Neutropenia is Less Frequent in Patients than in General Population: A Benign (Ethnic) Neutropenia Study. European Journal of Medical and Health Sciences, 2(6).