Neutropenia (cont.)

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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 (patients with low white blood cell counts) 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 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 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 or destruction of blood cells by the spleen
Medically Reviewed by a Doctor on 12/4/2013

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