Pediatric Diabetes

 Neutropenia in 6 cases of childhood onset type 1 diabetes and its possible mechanisms
Objective Type 1 diabetes (T1D) is a chronic inflammatory disease caused by a selective destruction of the pancreatic ?-cells. There are few reports on peripheral neutropenia in T1D for different reasons. We reported 6 cases of childhood onset T1D combined with neutropenia and explored its possible mechanisms. Methods The clinical diagnosis and treatment course of 6 cases of childhood onset T1D combined with neutropenia, who were hospitalized in our hospital from January, 2013 to December, 2016, were studied retrospectively. Results We have diagnosed and treated 38 cases of childhood onset T1D during these period, while only 6 cases (15.79%) had neutropenia. The diagnostic ages of the 6 cases ranged from 5 to 12 years. Diabetic ketoacidosis was complicated in 5 cases. Neutropenia happened within 14-21 days of the onset of disease and 3-11 days after using insulin, respectively, and returned spontaneously to normal range within 5-9 days. The serum levels of granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF) increased slightly before the usage of insulin in all 6 cases, and decreased to normal range after the usage of insulin. Conclusion Neutropenia can be seen in childhood onset T1D, and can return spontaneously to normal range without special treatments. The possible mechanisms might be the regulation effects of insulin on G-CSF and GM-CSF.