What Is Neutropenia?

Neutropenia is defined as lower-than-normal neutrophil levels in the blood. Neutrophils are a type of white blood cell that is primarily produced in the bone marrow. White blood cells in general, and neutrophils in particular, play an important role in the body’s infection control.

Neutropenia is classified as mild, moderate, or severe, based on the number of neutrophils in a blood sample. Many experts believe that the lowest acceptable limit for adults is around 1,500 neutrophils per microliter of blood, however, some say the cut-off point is 1,800 microliters.

Mild neutropenia has a neutrophil count of 1,000-1,500, moderate neutropenia has a count of 500-1,000, and severe neutropenia has a count of less than 500.

Neutropenia can also be classified as acute (temporary or short-term) or chronic (long-term), congenital (inherited) or acquired (a condition that happens over a period of time).

Neutropenia can strike anyone at any time. It can be caused by an infection, but it is also frequently caused by cancer treatment. It is estimated that half of those who receive chemotherapy will develop neutropenia.

Types of Neutropenia

There are several types of neutropenia, including:

Cyclic Neutropenia

Cyclic neutropenia is a rare congenital syndrome that causes fluctuations in neutrophil numbers; it affects approximately one in one million people.

Kostmann’s Syndrome

Kostmann’s syndrome is a genetic disorder in which neutrophils are produced at a reduced level. Kostmann’s syndrome patients are prone to infections from a young age.

Myelokathexis

This is a condition in which neutrophils fail to migrate from the bone marrow to the bloodstream.

Autoimmune Neutropenia

Autoimmune neutropenia occurs when the immune system attacks and destroys neutrophils.

Shwachman-Diamond Syndrome

Shwachman-Diamond syndrome is a rare genetic disorder characterized by dwarfism, pancreas problems, and a low neutrophil count.

Isoimmune Neonatal Neutropenia

This is a condition in which antibodies from the mother cross the placenta and attack the developing fetus’ neutrophils. This condition usually resolves itself within the first two months of life. It may be asymptomatic or cause sepsis.

Chronic Idiopathic Neutropenia

This is a common type of neutropenia that primarily affects women.

Causes of Neutropenia

Neutrophils are produced in the bone marrow at the center of larger bones. Neutropenia can be caused by anything that interferes with this process.

Most commonly, neutropenia is caused by cancer chemotherapy. In fact, nearly half of all cancer patients undergoing chemotherapy will develop neutropenia.

Other possible causes of neutropenia include:

• Alcoholism
• Vitamin deficiencies, most notably vitamin B12, folate, and copper deficiency.
• Sepsis: a bloodstream infection that consumes neutrophils faster than they can be produced.
• Pearson’s Syndrome
• Hypersplenism, also known as an enlarged spleen certain infections, such as hepatitis A, B, and C, HIV/AIDS, malaria, tuberculosis, dengue fever, and Lyme disease leukemia
• certain medications, such as antibiotics and medications for high blood pressure, psychiatric disorders, and epilepsy
• Barth syndrome is a genetic disorder that affects multiple systems.
• Myelodysplastic syndromes are a group of disorders characterized by dysfunctional blood cells caused by bone marrow production issues.

What Are the Symptoms of Neutropenia?

Neutropenia does not cause any symptoms. It is frequently discovered during routine blood tests or tests for another condition. Patients undergoing chemotherapy who are most at risk from the condition will have regular blood tests for this and other reasons.

The most serious concern with neutropenia is infection, which can easily spread throughout the body if there aren’t enough neutrophils to control it.

Infection symptoms include:

• Flu-like symptoms include a high fever or a low temperature, chills, and sweating.
• Malaise
• Mucositis which is a painful inflammation and ulceration of the digestive tract’s mucous membranes.
• Stomach aches
• Vomiting and diarrhea
• Alterations in mental state
• Coughing and increased urination
• Breathing difficulties
• Swelling or redness around wounds
• Atypical vaginal discharge
• Toothache, sore throat, or mouth sores
• Ache near the anus
• Urinating with a burning sensation

Diagnosing Neutropenia

These tests can be used by your doctor to diagnose neutropenia:

• CBC (complete blood count): This test determines the number of neutrophils in the
• body. Intermittent CBC tests can assist your doctor in monitoring neutrophil count changes three times per week for six weeks.
• Blood test for antibodies: This test looks for signs of autoimmune neutropenia.Bone marrow aspirate: This test looks for bone marrow cells.
• Cytogenetic and molecular analysis: This testing assists your healthcare provider in studying the cell structures.
• Biopsy of the bone marrow: This entails testing a piece of bone marrow’s bony part.

Treating Neutropenia

The treatment for neutropenia will be determined by the underlying cause of the disorder. Among the medical treatments available to help mitigate the effects of neutropenia are:

• Antibiotics: Antibiotics may be given as a preventative measure to reduce the likelihood of infection. They are frequently administered at a time when the neutrophil count is likely to be at its lowest.
• G-CSF (granulocyte-colony stimulating factor): is a glycoprotein that stimulates the bone marrow to produce neutrophils and other granulocytes and then releases them into the bloodstream. Filgrastim, a drug, is the most commonly used form of G-CSF.
• Granulocyte-macrophage colony-stimulating factor (GM-CSF): A naturally occurring glycoprotein that functions similarly to G-CSF. Both aid in neutrophil recovery following chemotherapy.

Lifestyle Precautions for Neutropenia

Individuals suffering from neutropenia must take some basic precautions in their daily lives.

They should eliminate as many potential sources of infection from their daily routine as possible. People with neutropenia should take the following precautions in their daily lives:

• Hands should be washed frequently with soap and water. Wash your hands before and after eating, using the toilet, touching pets or things outside your home, and coughing or sneezing.
• When you leave the house, keep an alcohol-based hand sanitizer with you and use it.
• If your doctor says you can, make sure you get the flu shot as soon as possible.
• Keep away from crowds and people who are ill.
• Make sure that raw fruits and vegetables are thoroughly washed.
• Separate raw meats, fish, and poultry from other foods.
• Before you begin cooking, clean the kitchen surfaces with hot water and soap.
• Cook foods until they reach the proper temperature.
• When gardening in the dirt or working in the yard, wear gloves.
• It is preferable not to pick up pet waste, however, if you must, ensure to use gloves. When you’re finished, wash your hands.
• Avoid getting body piercings or tattoos.
• Avoid swimming in lakes and ponds.
• If possible, avoid becoming constipated.
• Brush your teeth at least twice a day with a soft toothbrush.
• Every day, take a shower. Use lotion to keep your skin from drying out and cracking.
• Maintain a healthy diet.
• Share no eating utensils, cups, food, or beverages with others.
• Share no towels, razors, or toothbrushes with others.

Now that you Know…

Neutropenia is a condition that causes a decrease in the number of neutrophils; a type of white blood cell in the bloodstream, impairing the body’s ability to fight infections. Neutropenia is defined as having an absolute neutrophil count (ANC) of less than 1500 per microliter (1500/microL), while severe neutropenia has an ANC of less than 500/microL.

Neutropenia can be caused or exacerbated by a variety of medical conditions, including congenital bone marrow disorders, cancer chemotherapy, infections, certain medications (drug-induced neutropenia), and autoimmune disorders. Treatment is determined by the cause and severity of the condition, as well as the underlying disease state causing neutropenia.

Neutropenia makes you more susceptible to bacterial infections. The degree of risk is determined by the cause and severity of the neutropenia, the patient’s underlying medical condition, and the presence or absence of bone marrow reserves for neutrophil production. The majority of infections that occur as a result of neutropenia are caused by bacteria that are normally found on the skin, in the gastrointestinal tract, or in the urinary tract.

In order to reduce the risk of infection in neutropenic patients, preventive measures may be implemented. These precautions may include strict hand washing, the use of private rooms, or, in some cases, the use of gloves, gowns, and/or face masks by caregivers.