Abstract
A preterm male infant with a patent ductus arteriosus developed neutropenia during treatment with indomethacin. Afterward, the mother described her own history of indomethacin-associated neutropenia. During the recovery from the neutropenia, the infant became septic with bacteremia caused by Enterobacter cloacae. Although indomethacin-related neutropenia has been described in adults, no case in a neonate has been reported. If neutropenia occurs after indomethacin therapy in a neonate, a familial history of indomethacin-associated neutropenia should be sought and the increased risk of infection should be considered.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Van Overmeire B, Chemtob S . The pharmacologic closure of the patent ductus arteriosus. Semin Fetal Neonatal Med 2005; 10: 177–184.
Strom BL, Carson JL, Schinnar R, Snyder ES, Shaw M, Lundin Jr FE . Nonsteroidal anti-inflammatory drugs and neutropenia. Arch Intern Med 1993; 153: 2119–2124.
van der Klauw MM, Wilson JH, Stricker BH . Drug-associated agranulocytosis: 20 years of reporting in The Netherlands (1974–1994). Am J Hematol 1998; 57: 206–211.
Juul SE, Haynes JW, McPherson RJ . Evaluation of neutropenia and neutrophilia in hospitalized preterm infants. J Perinatol 2004; 24: 150–157.
Christensen RD, Calhoun DA, Rimsza LM . A practical approach to evaluating and treating neutropenia in the neonatal intensive care unit. Clin Perinatol 2000; 27: 577–601.
Calhoun DA, Christensen RD . Recent advances in the pathogenesis and treatment of nonimmune neutropenias in the neonate. Curr Opin Hematol 1998; 5: 37–41.
Juul SE, Haynes JW, McPherson RJ . Evaluation of neutropenia and neutrophilia in hospitalized preterm infants. J Perinatol 2004; 24: 150–157.
Fraser SH, Tudehope DI . Neonatal neutropenia and thrombocytopenia following maternal hypertension. J Paediatr Child Health 1996; 32: 31–34.
Baley JE, Stork EK, Warkentin PI, Shurin SB . Neonatal Neutropenia: clinical manifestations, cause, and outcome. Am J Dis Child 1988; 142: 1161–1165.
Herson VC, Krause PJ, Eisenfeld LI, Pontius L, Maderazo EG . Indomethacin-associated sepsis in very-low-birth weight infants. Am J Dis Child 1988; 142: 555–558.
Yeh TF, Goldbarg HR, Henck T, Thalji A, Pildes RS . Intravenous indomethacin therapy in premature infants with patent ductus arteriosus. Cause of death and one-year follow-up. Am J Dis Child 1982; 136: 802–807.
Bandstra ES, Montalvo BM, Goldberg RN, Pachecco I, Flynn J, Gregorios JB et al. Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. Pediatrics 1988; 82: 533–542.
Strom BL, Carson JL, Schinnar R, Snyder ES, Shaw M, Lundin FE . Nonsteroidal anti-inflammatory drugs and neutropenia. Arch Intern Med 1993; 153: 2119–2124.
Carson JL, Willett LR . Toxicity of nonsteroidal anti-inflammatory drugs. An overview of the epidemiological evidence. Drugs 1993; 46 (Suppl 1): 243–248.
The international agranulocytosis and aplastic anemia study. Risks of agranulocytosis and aplastic anemia. A first report of their relation to drug use with special reference to analgesics. JAMA 1986; 256: 1749–1757.
Young GA, Vincent PC . Drug-induced agranulocytosis. Clin Haematol 1980; 9: 483–504.
Mease AD . Tissue neutropenia: the newborn neutrophil in perspective. J Perinatol 1990; 10: 55–59.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bengtsson, BO., Milstein, J. & Sherman, M. Indomethacin-associated neutropenia with subsequent Gram-negative sepsis in a preterm infant. Cause or coincidence?. J Perinatol 26, 381–383 (2006). https://doi.org/10.1038/sj.jp.7211515
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211515