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Isolated Neutropenia/Benign Ethnic Neutropenia: A Common Clinical and Laboratory Finding in Southern and Western Saudi Arabia

Authors Awan ZA, Al Amoudi SM, Saboor M, Alkhaldy HY

Received 6 January 2021

Accepted for publication 28 January 2021

Published 15 February 2021 Volume 2021:14 Pages 451—457

DOI https://doi.org/10.2147/IJGM.S300690

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Zuhier A Awan,1,2 Saeed M Al Amoudi,2 Muhammad Saboor,3,4 Husain Y Alkhaldy5,6

1Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia; 3Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gazan, Saudi Arabia; 4Medical Research Centre (MRC), Jazan University, Jazan, Saudi Arabia; 5Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia; 6Research Center for Advanced Materials Science, King Khalid University, Abha, Saudi Arabia

Correspondence: Husain Y Alkhaldy
Department of Internal Medicine, College of Medicine, Research Center for Advanced Materials Science, King Khalid University, P.O.Box 9004, Abha, 61413, Saudi Arabia
Tel +966599915567
Email halkhaldy@kku.edu.sa

Objective: Isolated mild neutropenia is a common clinical problem in some ethnicities including Arabs and Middle Eastern population. The current study aims to authenticate the prevalence of isolated neutropenia in Southern and Southwestern Saudi Arabia, explore the effect of altitude or regional differences and to suggest a new reference range for neutrophil count.
Methods: In this retrospective cross-sectional study, laboratory results of a commercial laboratory were screened over a period of 5 years (2016– 2020) in seven different cities of different altitudes in South and southwestern Saudi Arabia. Participants’ laboratory investigations were reviewed and excluded for any abnormal complete blood count, renal profile, liver profile, lipid profile, thyroid function test, fasting blood glucose, or HbA1c findings. Descriptive analysis and 95th percentile range were calculated using standard statistical methods.
Results: A total of 91,880 complete blood count results were included in the final analysis. Isolated neutropenia was common laboratory finding, with a prevalence ranging from 11% to 23%. The 2.5th percentile of the neutrophil count was lower than currently utilized 1.5× 109/L in all studied seven cities.
Conclusion: Mild to moderate neutropenia is common in Southern and Southwestern Saudi Arabia. Benign ethnic neutropenia (BEN) likely explains this high prevalence. Since BEN has no clinical significance, the reference range for normal neutrophil counts needs to be adjusted to reflect the effect of BEN.

Keywords: isolated neutropenia, benign ethnic neutropenia, reference intervals, Saudi Arabia

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