Neutropenia (cont.)
What are the clinical consequences of neutropenia?
Neutropenia results in an increased susceptibility to bacterial infections.
The degree of risk depends upon the cause and severity of the neutropenia, the
underlying medical condition of the patient, and the presence or absence of bone
marrow reserves for the production of neutrophils.
The most common type of infections seen in neutropenic
patients are caused by bacteria normally found on the skin (such as
Staphylococcus aureus) or from the gastrointestinal and urinary tract.
Fungal
infections are also more frequent in
patients with neutropenia. The infections may be limited to certain areas of the
body (commonly the oral cavity, genital area, and skin)
or may spread via the bloodstream to the lungs and other organs in severe, prolonged neutropenia.
What causes neutropenia?
Neutropenia can be present (though it is relatively
uncommon) in normal healthy individuals, notably in some persons of African or
Arabic descent and and Yemenite Jews. Neutropenia may arise as a result of
decreased production of neutrophils, destruction of neutrophils after they are
produced, or pooling of neutrophils (accumulation of the neutrophils out of the
circulation).
Neutropenia may arise as a result of numerous medical conditions:
- Infections (more commonly viral infections, but also
bacterial or parasitic infections). Examples include:
HIV,
tuberculosis,
malaria,
Epstein Barr virus (EBV);
- Medications that may damage the bone marrow or
neutrophils, including cancer
chemotherapy;
- Vitamin deficiencies (megaloblastic
anemia due to
vitamin B12 and/or folate
deficiency);
- Diseases of the bone marrow such as
leukemias,
myelodysplastic syndrome,
aplastic anemia,
myelofibrosis;
- Radiation therapy;
- Congenital (inborn) disorders of bone marrow function
or of neutrophil production, for example,
Kostmann syndrome;
- Autoimmune destruction of neutrophils (either as a
primary condition or associated with another disease such as
Felty's syndrome)
or from drugs stimulating the immune system to attack the cells
- Hypersplenism, which refers to the increased
sequestration and/or destruction of blood cells by the spleen
Next: How is neutropenia diagnosed? »
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