(Agranulocytosis; Granulocytopenia; Granulopenia)
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
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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:
- Underlying inflammatory condition
- 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
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—
- Mouth sores
- Bleeding gums
- Mild infections of skin, mouth, and nose
- Poor weight gain in children
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
Care is based on the cause and how serious the condition is. It may involve:
- 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.
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.
Mouth Healthy—American Dental Association
NORD———National Organization for Rare Disorders
The College of Family Physicians of Canada
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:
. Updated December 29, 2017. Accessed July 13, 2018.
Last reviewed May 2018 by
EBSCO Medical Review Board
Michael J. Fucci, DO, FACC
Last Updated: 7/13/2018