Carl R. Darnall Army Medical Center - Health Library

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 ^

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 ^

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 ^

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 ^

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 ^

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 ^

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:

Health Canada
https://www.canada.ca

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.com/topics/dmp~AN~T116576/Neutropenia-approach-to-the-patient. 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