Neutropenia (noo-troe-PEE-nee-uh) is an abnormally low depend of neutrophils, a kind of white blood cell that helps combat off infections, notably these attributable to micro organism and fungi.
The threshold for outlining neutropenia varies barely from one medical observe to a different. Neutropenia in adults is usually outlined as a depend of 1,700 or fewer neutrophils per microliter of blood. The cell depend indicating neutropenia in kids varies with age.
The decrease your neutrophil depend, the extra susceptible you might be to infectious illnesses. If you will have extreme neutropenia fewer than about 500 cells per microliter of blood micro organism usually current in your mouth and digestive tract could cause infections.
Symptoms of Neutropenia
Neutropenia itself usually would not trigger signs. In some instances, individuals solely be taught they’ve neutropenia once they have a blood take a look at for an unrelated motive. But individuals might produce other signs from an infection or the underlying downside inflicting the neutropenia.
Infections can happen as a complication of neutropenia. They happen most frequently within the mucous membranes, equivalent to the within of the mouth and the pores and skin.
These infections can seem as:
- Abscesses (collections of pus)
- Wounds that take a very long time to heal
- Fever can be a standard symptom of an infection.
The danger for critical an infection typically will increase as:
- Neutrophil depend goes down
- Duration of extreme neutropenia will get longer
Causes of Neutropenia
Neutropenia can develop if neutrophils are used up or destroyed within the bloodstream sooner than the bone marrow could make new ones. With some bacterial infections, some allergic problems, and a few drug remedies, neutrophils are destroyed sooner than they’re produced. People with an autoimmune illness could make antibodies that destroy neutrophils and end in neutropenia. People with an enlarged spleen (see see Enlarged Spleen) might have a low neutrophil depend as a result of the enlarged spleen traps and destroys neutrophils.
Neutropenia may develop if the manufacturing of neutrophils within the bone marrow is lowered, as can happen in some individuals with most cancers, viral infections equivalent to influenza, bacterial infections equivalent to tuberculosis, myelofibrosis, or deficiencies of vitamin B12 or folate (folic acid). People who’ve acquired radiation remedy that includes the bone marrow may develop neutropenia. Many medicine, together with phenytoin, chloramphenicol, sulfa medicine, and plenty of medicine utilized in most cancers therapy (chemotherapy), in addition to sure toxins (benzene and pesticides) may impair the bone marrow’s capacity to supply neutrophils.
How is Neutropenia Treated?
Treatment of neutropenia relies upon the underlying trigger, severity, and the presence of related infections or signs in addition to the general well being standing of the affected person. Obviously, therapy should even be directed towards any underlying illness course of. Treatments that immediately tackle neutropenia might embrace (word that every one of those remedies will not be acceptable in a given setting):
- antibiotic and/or antifungal drugs to assist combat infections;
- administration of white blood cells progress components (equivalent to recombinant granulocyte colony-stimulating issue (G-CSF, filgrastim) in some instances of extreme neutropenia;
- granulocyte transfusions; or
- corticosteroid remedy or intravenous immune globulin for some instances of immune-mediated neutropenia.
Preventive measures may be applied in neutropenic sufferers to restrict danger of infections. These measures may embrace strict consideration at hand washing, use of personal rooms, or in some instances, use of gloves, robes, and/or face masks by caregivers.