Neutropenia

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Mary Nettleman, MD, MS

• What is neutropenia?
• How is neutropenia defined?
• What are the clinical consequences of neutropenia?
• What causes neutropenia?
• How is neutropenia diagnosed?
• How is neutropenia treated?
• Neutropenia At A Glance
• Patient Discussions: Neutropenia - Describe Your Experience

Featured neutropenia patient discussions on experience with the condition "My daughter has neutropenia. Her neutrophils count varies from 1 to 2%. She was diagnosed after a fever; she also had small blisters in her mouth. She always asks for water, so we presume she is always thirsty. She is 1 year old and nobody really knows why she has it." "I have two children. My 4-year-old daughter has been diagnosed and my 18-month-old little girl too. They have both been on folic acid from birth as they are pre-term babies, but this is a condition that has grown progressively worse. They are both classed as Chronic Neutropenia cases now. My 4-year-old did get her numbers to an acceptable level, but they have recently dipped again. She is always pale, but my baby is yellowish. We are awaiting bone marrow tests again!" "I am 44 years old and was diagnosed with neutropenia in my 20's. I had the bone marrow tests twice and the only thing they believe contributed to this condition is that when I was 10 years old I had my appendix out in another country and was given a very strong antibiotic (chloromycetin) that was outlawed in the US and they think the drug damaged my bone marrow. Overall, I lead a healthy life, but I need to watch for infections closely and see the doctor right away if I get sick. Sometimes, even with antibiotics, I have a hard time fighting illness or getting over coughs. I always get the flu shot. I have some family members who also have somewhat low white blood cell counts, but not as badly as I do." Read all comments on neutropenia » Top Searched Neutropenia Terms: fever, causes, psoriatic arthritis, autoimmune, seizures, mumps, chemotherapy, leukopenia, agranulocytosis, thrombocytopenia Patient Discussions are not a substitute for professional medical advice, or treatment. See the disclaimer at the bottom of the comments page.

What is neutropenia?

"Neutropenia" is a condition in which the number of neutrophils in the bloodstream is decreased. Neutrophils are a type of white blood cell also known as polymorphonuclear leukocytes or PMNs. Neutropenia affects the body's ability to fight off infections.

White blood cells are also known as leukocytes. There are five major types of white blood cells:

1. basophils,
   
   
2. eosinophils,
   
   
3. lymphocytes (T-cells and B-cells),
   
   
4. monocytes, and
   
   
5. neutrophils.

Some white blood cells, called granulocytes, are filled with microscopic granules that are little sacs containing enzymes (compounds that digest microorganisms). Neutrophils, eosinophils, and basophils are all granulocytes and are part of the innate immune system with somewhat nonspecific, broad-based activity. They do not respond exclusively to specific antigens, as do the lymphocytes (B-cells and T-cells).

Neutrophils contain enzymes that help the cell kill and digest microorganisms it has engulfed by a process known as phagocytosis. The mature neutrophil has a segmented nucleus (it is often called a 'seg' or 'poly'), while the immature neutrophil has a band-shape nucleus (it is called a band). Neutrophils are made in the bone marrow and released into the bloodstream. The neutrophil has a life-span of about three days.

How is neutropenia defined?

The white blood cell count (WBC) is the number of white blood cells in a volume of blood. The normal range for the WBC varies slightly among laboratories but is generally between 4,300 and 10,800 cells per microliter or cubic millimeter (cmm). The WBC can also be referred to as the leukocyte count and can be expressed in international units as 4.3 x 109to 10.8 x 109 cells per liter. The percentage of the different types of white blood cells in the WBC is called the WBC differential.

The absolute neutrophil count (ANC) is determined by the product of the white blood cell count (WBC) and the fraction of neutrophils among the white blood cells as determined by the WBC differential analysis. For example, if the WBC is 10,000 per microliter and 70% are neutrophils, the ANC would be 7,000 per microliter.

An ANC of less than 1500 per microliter (1500/microL) is the generally accepted definition of neutropenia. Neutropenia is sometimes further classified as:

• mild if the ANC ranges from 1000-1500/microL,
  
  
• moderate with an ANC of 500-1000/microL, and
  
  
• severe if the ANC is below 500/microL.

Some medical terms may be used synonymously with neutropenia, even though their precise definitions are different.

• Leukopenia refers to a reduced number of white blood cells in general, while granulocytopenia refers to a decreased number of all the granulocyte-type blood cells (neutrophils, eosinophils, and basophils).
  
  
• Since neutrophils normally far outnumber the other types of granulocytes, this term is sometimes used to refer to neutropenia.
  
  
• Finally, agranulocytosis literally refers to a complete absence of all granulocytes, but this term is sometimes used to refer to severe neutropenia.

Neutropenia - Describe Your Experience

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