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: 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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Comment from: Kathy, 45-54 Female (Patient) Published: April 30

I have had autoimmune neutropenia for over 10 years now! My current CBC was, WBC 1.8, and ANC 600. I have had multiple bone marrow biopsies, which have turned up nothing. No explanation. Over the past couple of years it has gotten worse, the mouth sores, skin boils, infections, chronic fatigue, muscle pain; this really knocks you down. I have had to be on Neupogen twice in the past two years, but we try to keep it limited as the side effects I get are terrible! There is not much information out there, but I keep looking! My best advice to everyone is to stay positive and capitalize on your good days, and rest on your bad days!

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