Neutropenia

(Agranulocytosis; Granulocytopenia; Granulopenia)

Pronounced: new-tro-pe-ne-uh

Definition

Neutropenia is an abnormally low number neutrophils in the blood. These are a type of white blood cell that helps fight infection.

There are 2 types:

  • Acquired—Appears after medical care or certain medicines. It can happen quickly or grow slowly over time.
  • Congenital—Present at birth.

White Blood Cells

White Blood Cells
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Causes    TOP

Causes of neutropenia:

  • Destruction of white blood cells
  • The body uses up white blood cells to fight an infection
  • The failure of bone marrow to make enough white blood cells

Defects with your genes cause the congenital type.

Acquired type causes:

  • Infections
  • Underlying inflammatory condition
  • Chemotherapy
  • Certain medicines
  • Illegal drug use
  • Immune system problems
  • Certain toxins
  • Poor nutrition—mainly from low protein intake

Risk Factors    TOP

Your chances of neutropenia are higher if you:

  • Are using chemotherapy to treat cancer
  • Take certain medicines such as antidepressants or antihistamines
  • Have an infection
  • Are exposed to certain chemicals or radiation
  • Have immune system problems
  • Don’t take enough vitamin B-12 or folate
  • Have bone marrow diseases
  • Have people in your family with certain genetic problems

Symptoms    TOP

Most people don’t have symptoms. But, neutropenia can lead to an infection. This may cause:

  • Fever or chills—may come on quickly
  • Lack of strength
  • Sore throat
  • Yellowish skin or whites of the eyes—jaundice
  • Mouth sores
  • Bleeding gums
  • Mild infections of skin, mouth, and nose
  • Poor weight gain in children

Diagnosis    TOP

You will be asked about your symptoms and medical history. You will be asked about recent infections, medical treatments, and medications. A physical exam will be done.

The doctor will ask about your symptoms and health history. You may have:

  • A physical exam
  • Blood tests
  • Bone marrow test
  • Urine tests

Treatment    TOP

Care is based on the cause and how serious the condition is. It may involve:

Medicines to:

  • Treat infections—either the cause or result of neutropenia
  • Prevent infections in people who are at high risk
  • Stimulate white blood cell production

Changing or avoiding medicines or toxins causing problems.

Prevention    TOP

If you are at high risk for neutropenia, your doctor will watch you for any changes. Sometimes, medicines to stimulate white blood cell production are given in ahead of time.

RESOURCES:

Mouth Healthy—American Dental Association
https://www.mouthhealthy.org
NORD———National Organization for Rare Disorders
https://rarediseases.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Boulton F, Cooper C, Hagenbeek A, Inskip H, Leufkens HG. Neutropenia and agranulocytosis in England and Wales: incidence and risk factors. Am J Hematol. 2003;72(4):248-254.
Neutropenia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/leukopenias/neutropenia. Updated November 2016. Accessed July 13, 2018.
Neutropenia—approach to the patient. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 29, 2017. Accessed July 13, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 7/13/2018

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