neutropenia

Neutropenia: A Condition Characterized by Low Neutrophil Count

Neutropenia is a condition characterized by an abnormally low number of neutrophils, which are granulated leukocytes crucial for the initial defense against infections [1]. This reduction in neutrophil count can increase the risk and severity of bacterial and fungal infections [2].

Definition and Prevalence

Neutropenia is defined as a decrease in circulating neutrophils, with only about 4-5% of total body neutrophil stores contained in the central circulation [3]. This condition affects a small percentage of the population, but can have significant implications for those affected.

Causes and Characteristics

Numerous factors may cause neutropenia through destruction, decreased production or abnormal storage of neutrophils [8]. Neutropenia is characterized by an abnormally low number of circulating neutrophils (segmented cells and bands) in the peripheral blood with a corresponding decrease in the absolute number of neutrophils in blood circulation [7].

Key Points

• Neutropenia is a condition characterized by an abnormally low number of neutrophils.
• The reduction in neutrophil count can increase the risk and severity of bacterial and fungal infections.
• Neutropenia can be caused by various factors, including destruction, decreased production or abnormal storage of neutrophils.

References

[1] AAJ Vaillant · 2022 · Cited by 5 [2] [3] May 23, 2024 [7] Sep 14, 2022 [8]

Common Signs and Symptoms of Neutropenia

Neutropenia, a condition characterized by an abnormally low count of neutrophils (a type of white blood cell), can manifest in various ways. While some people may not experience any symptoms at all, others may exhibit the following signs:

• Fever: A fever is often one of the first signs of infection in individuals with neutropenia. If your temperature exceeds 100.4°F (38°C) or higher, it's essential to seek medical attention immediately [1][2].
• Infections: Neutropenia increases the risk of infections, which can be severe and life-threatening if left untreated [3]. Common signs of infection include fever, chills, sweats, a new or worsening cough, shortness of breath, mouth sores, sore throat, and changes in skin or mucous membranes.
• Fatigue: Feeling extremely tired or exhausted is another symptom associated with neutropenia [4].
• Mouth ulcers: Painful mouth ulcers can be a sign of neutropenia, particularly if they are recurrent or persistent [5].
• Skin infections: Skin abscesses, swollen gums, and skin infections are also potential symptoms of neutropenia [6][13].

It's essential to note that some people with neutropenia may not exhibit any specific symptoms at all. In such cases, the condition is often diagnosed when an infection occurs.

References:

[1] Context result 2: "When you’re sick, more neutrophils are released, causing other WBC levels to go down."

[2] Context result 4: "While not one of the four main ... than 101 F or a fever of at least 100.4 F that lasts an hour or more can be a sign of a dangerous infection."

[3] Context result 9: "Typically, only people with severe neutropenia are at risk of life-threatening infections."

[4] Context result 5: "feeling sick (nausea) · extreme tiredness (fatigue)"

[5] Context result 13: "Symptoms and signs of neutropenia include fever, skin abscesses, mouth sores, swollen gum, and skin infections."

[6] Context result 14: "Neutropenia describes a significant reduction in a type of white blood cell called neutrophils. Produced in bone marrow, these are an essential first line of defense against infections."

Diagnostic Tests for Neutropenia

Treatment Options for Neutropenia

Neutropenia, a condition characterized by an abnormally low count of white blood cells (WBCs), can be treated with various medications to manage symptoms and prevent complications.

• Antibiotics: Antibiotic treatment is often necessary when neutropenia is accompanied by fever (febrile neutropenia). Experts agree that patients with acute febrile neutropenia should be treated with antibiotics [3]. For empiric outpatient therapy, the ASCO/IDSA guidelines recommend an oral fluoroquinolone plus amoxicillin/clavulanate (or clindamycin, if the patient is allergic to penicillins) [4].
• Antiviral and antifungal medications: In some cases, antiviral or antifungal medicines may be prescribed when neutropenia is accompanied by a viral or fungal infection.
• Myeloid growth factors: These medications can help stimulate the production of WBCs in patients with neutropenia [7].
• Steroids and intravenous immunoglobulin: In rare cases, steroids or intravenous immunoglobulin may be used to treat associated autoimmune conditions.

Key Considerations

• Febrile neutropenia is a serious condition that requires prompt treatment with antibiotics.
• Antibiotic prophylaxis may be recommended in some cases to reduce the risk of infection.
• Treatment should be individualized based on the underlying cause and severity of neutropenia.

References:

[1] Dec 7, 2023 — Neutropenia Treatment · Antibiotics for fever [2] What are the treatments for neutropenia? · Antibiotics: Antibiotic treatment can save your life if you have neutropenia with a fever (febrile neutropenia). [3] by DC Dale · 2016 · Cited by 74 — Experts agree that patients with acute febrile neutropenia should be treated with antibiotics and that patients at high risk of severe ... [4] May 23, 2024 — For empiric outpatient therapy, the ASCO/IDSA guidelines recommend an oral fluoroquinolone plus amoxicillin/clavulanate (or clindamycin, if the ... [7] Treatment of Neutropenia · Treatment of associated conditions (eg, infections, stomatitis) · Sometimes antibiotic prophylaxis · Myeloid growth factors.

Differential Diagnosis of Neutropenia

Neutropenia, a condition characterized by low levels of neutrophils (a type of white blood cell) in the blood, has a broad differential diagnosis. The following are some of the key causes:

• Congenital Neutropenias: These are rare genetic disorders that affect the production or function of neutrophils.
  • [5] Congenital neutropenias can present with recurrent infections and low neutrophil counts, particularly in young patients without a known history of previous infections.
• Infectious Causes: Infections, such as bacterial sepsis, can lead to neutropenia by consuming neutrophils or damaging the bone marrow.
  • [2] Neutropenia can result from decreased production, accelerated utilization, increased destruction, or change in location of neutrophils, making infections a significant cause.
• Rheumatologic and Iatrogenic Causes: Certain autoimmune disorders, such as rheumatoid arthritis, and iatrogenic factors, like cancer treatments, can also contribute to neutropenia.
  • [6] The differential diagnosis of neutropenia is broad and encompasses these various causes.

Key Points

• Neutropenia has a wide range of potential causes, including congenital, infectious, rheumatologic, and iatrogenic factors.
• Congenital neutropenias are rare genetic disorders that affect neutrophil production or function.
• Infections can lead to neutropenia by consuming neutrophils or damaging the bone marrow.
• Rheumatologic and iatrogenic causes, such as autoimmune disorders and cancer treatments, also contribute to neutropenia.

References

[2] Neutropenia can result from: decreased production, accelerated utilization, increased destruction, or change in location of neutrophils, or any combination of these factors. [5] Congenital neutropenias can present with recurrent infections and low neutrophil counts, particularly in young patients without a known history of previous infections. [6] The differential diagnosis of neutropenia is broad and encompasses congenital, infectious, rheumatologic, and iatrogenic causes.