What is Neutropenia?
Neutropenia is a low level of neutrophils, a type of white blood cell. All white blood cells help the body fight infection. Neutrophils fight infection by destroying harmful bacteria and fungi or yeast that invades the body. Neutrophils are made in the bone marrow. Bone marrow is the spongy tissue found inside larger bones such as the pelvis, vertebrae, and ribs.
Some level of neutropenia occurs in about half of people with cancer who are receiving chemotherapy. It is a common side effect in people with leukemia. If you have neutropenia, pay close attention to personal hygiene, such as hand washing, to lower your risk of infection.
Causes of Neutropenia
Neutrophils are produced in the bone marrow at the center of larger bones. Anything that disrupts this process can cause neutropenia. Most commonly, neutropenia is caused by chemotherapy for cancer. In fact, around half of cancer patients undergoing chemotherapy will experience some level of neutropenia.
Other potential causes of neutropenia include:
- Leukemia: a group of blood cell cancers
- Barth syndrome: an X-linked genetic disorder affecting multiple systems
- Myelodysplastic syndromes: a group of disorders characterized by dysfunctional blood cells due to problems with bone marrow production
- Myelofibrosis: a rare bone marrow problem, also known as osteomyelofibrosis
- Alcohol use disorder: including alcoholism
- Vitamin deficiencies: most commonly, vitamin B12, foliate, and copper deficiency
- Sepsis: an infection of the bloodstream that uses up neutrophils quicker than they can be produced
- Pearson syndrome: a mitochondrial disease
- Some infections: including hepatitis A, B, and C, HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome), malaria, and Lyme disease
- Hypersplenism: an enlarged spleen due to sequestration of blood cells
Premature babies are more likely to be born with neutropenia than babies born near their due date; the condition affects 6-8 percent of newborns in neonatal intensive care units. As a general rule, the smaller the baby, the more likely they are to have neutropenia.
Symptoms of Neutropenia
Common presenting symptoms of neutropenia include the following:
- Low-grade fever
- Sore mouth
- Gingival pain and swelling
- Skin abscesses
- Recurrent sinusitis and otitis
- Symptoms of pneumonia (eg, cough, dyspnea)
- Perirectal pain and irritation
Patients with agranulocytosis usually present with the following:
- Sudden onset of malaise
- Sudden onset of fever, possibly with chills and prostration
- Stomatitis and periodontitis accompanied by pain
- Pharyngitis, with difficulty swallowing
Diagnosis of Neutropenia
- Complete blood count
- Bone marrow examination
When people have frequent or unusual infections or if people are taking drugs known to cause neutropenia, doctors order a blood test (complete blood count) to make the diagnosis. A low neutrophils count indicates neutropenia.
In many cases, the neutropenia is expected and the cause is known, as in people receiving chemotherapy or radiation therapy. When the cause is not known, it must be determined. And whether the cause is known or not, doctors usually also search for a hidden infection that may have been caused by the neutropenia.
Treatment of Neutropenia
- Treatment of associated conditions (eg, infections, stomatitis)
- Sometimes antibiotic prophylaxis
- Myeloid growth factors
- Discontinuation of suspected etiologic agent (eg, drug)
- Sometimes corticosteroids
- Rarely splenectomy
By : Natural Health News