Neutropenia - Symptoms

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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.
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See what others are saying

Comment from: janleigh1, 55-64 Female (Patient) Published: January 02

I was diagnosed in 2001 after my white count began to decrease. I also had a neurological reaction to the flu shot several years ago and then a less serious neurological reaction to the flu a couple of years later. I was diagnosed with multiple sclerosis. I saw an MS specialist in Houston who said I did not have MS. I have the autoimmune type of neutropenia. The doctors have been trying different amounts of Neupogen, but it only lasts about 36 hours and then my counts are down again. The Neulasta only lasted about 6 days, but I couldn't tolerate the side effects. I have been hospitalized about 5 times in the last 13 years for infections and fevers. I have to wear a mask when I fly and avoid crowded places. I wash my hands all the time, but I have been around my 2 year granddaughter when she is sick and I don't seem to get sick. A doctor said that he thought my other kinds of white cells were taking over a bit for my lack of neutrophils even though that count is also low. Two bone marrow biopsies and many doctors and all I got is a prescription for an antimicrobial body wash and mouthwash and finally the Neupogen. This has really affected my ability to work, but many people have it worse and the Neupogen cuts down my exposure time.

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Comment from: Cactuspooch, 19-24 Female (Patient) Published: October 30

Ever since I was a baby, my dad remembers I got these odd skin lesions. They continued, as I got older those 'skin lesions' got blown off as acne. Dermatologists even thought so, after all the lesions despite being inflamed and an off color, never showed signs of pus. Doctors noted the cultures always came back positive for MRSA. At 17 I saw a doctor specializing in infectious diseases. He tested me and made the realization I was living my whole life with neutropenia, ANC of 521. I get skin lesions, everywhere. Lately as I've gotten older it gets worse, I recently went to the hospital. Bacteria had entered my blood and infected my lungs and intestines. Now I'm on 100mg of Minocin daily for the rest of my life. Septra won't work anymore and the clindamycin is too dangerous to take for too long. I find myself lucky that I've lived for as long as I have, especially to have had it as a baby. I hope I continue to live. Sometimes I doubt the antibiotics are healthy to take long term but I realize that day I went to the hospital I could've died that night. I felt closer to death that night than I ever have, I thought I was going to fall asleep and pass away. It's scary, especially when you don't have insurance.

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