Q. What can cause fluctuations in absolute neutrophil count in a 2-year-old?

Answered by
Dr. Mubashir Razzaq Khan
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 28, 2021

Hello doctor,

My 2-year-old daughter is having fluctuations in her absolute neutrophil count. She does not have any signs of infection or fever. What can be the reason for these fluctuations?

Kindly help.



Welcome to

I went through the report of your child (attachments removed to protect the patient’s identity). Everything is normal in her report. Actually, in infants and young children, the immunity is antibody-mediated (humoral immunity). It is because of repeated vaccinations. The immunity would become cell-mediated by the age of 4 years.

The neutrophil counts concern only during a fever or infection. So, you need not worry.

Take care.

Hello doctor,

Thanks for the reply.

Her vitamin B12 levels and folic acid levels are fine. She has hair loss, night sweats, and shortness of breath when wearing a mask or after physical activity. I am worried that this may be related to a bone marrow disorder or blood cancer.

Kindly help.



Welcome back to

Neutropenia is low levels of absolute neutrophil in blood.

Grades of neutropenia are as follows:

Grade 0: more than 2000 cells/mm³.

Grade 1: 1500 to 2000 cells/mm³.

Grade 2: 1000 to 1500 cells/mm³.

Grade 3: 500 to 1000 cells/mm³.

Grade 4: 500 cells/mm³.

Grade 5 or critical: less than 100 cells/mm³.

It is evaluated through CRP (C-reactive protein), LDH (lactate dehydrogenase), urine culture, chest x-ray, and abdominal ultrasound. The symptoms include recurrent fever not responding to antibiotics, chest congestion, upper respiratory infections, boils on the skin, gastrointestinal infections, and UTI (urinary tract infection).

Your child is fine, and she do not have any underlying disease like blood cancer or bone marrow disorder. So, do not worry.

Take care.

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