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Neutropenia(Agranulocytosis; Granulocytopenia; Granulopenia)

Pronounced: new-tro-pe-ne-uh

Definition

Neutropenia is the bone marrow’s inability to produce enough neutrophils, a type of white blood cell that helps to fight infections.

Neutropenia may be:

  • Acquired—Develops after medical treatment or specific drugs; may appear suddenly or develop over time
  • Congenital—Present at birth

White Blood Cells

White Blood Cells

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Causes

Neutropenia can be caused by destruction or using up white blood cells and/or by the failure of bone marrow to make enough white blood cells.

With congenital neutropenia, these problems are caused by a genetic defect.

With acquired neutropenia, these problems may be caused by:

  • Infections by virus, bacteria, or parasite
  • Underlying inflammatory condition
  • Chemotherapy
  • Drugs—used in medical treatment or recreational use
  • Autoimmune disease—your immune systems attacks your own tissue such as white blood cells
  • Damage to bone marrow usually by chemicals, radiation, or cancers
  • Certain toxins
  • Poor nutrition—particularly low protein intake
Risk Factors

Factors that increase your chance of developing neutropenia include:

  • Undergoing chemotherapy treatment for cancer
  • Taking certain medications, including some antithyroid medication, antidepressants, antihistamines, and anticonvulsants
  • Infection, especially viruses
  • Exposure to certain chemical toxins or radiation
  • Autoimmune diseases
  • Enlargement of the spleen
  • Vitamin B-12 or folate deficiency
  • Leukemia or myelodysplastic syndromes
  • Aplastic anemia or other diseases of the bone marrow
  • Family history of certain genetic diseases
Symptoms

Neutropenia does not result in symptoms. However, it can result in infection, which may have the following symptoms:

  • Rapid onset of fever and chills
  • Weakness
  • Sore throat
  • Yellow skin color known as jaundice
  • Mouth sores
  • Bleeding gums
  • Mild infections of skin, mouth, and nose
  • Poor weight gain in children
Diagnosis

You will be asked about your symptoms and medical history. You will be asked about recent infections, medical treatments, and medications. A physical exam will be done.

Your bodily fluids and tissues may be tested. This can be done with:

  • Blood tests
  • Bone marrow test
  • Urine tests
Treatment

Treatment will be based on the cause and severity of your neutropenia. Options include the following:

Medication for Infections Treatment

Antiviral, antibiotic, and antifungal medication may be needed to:

  • Treat an infection that could be causing neutropenia
  • Treat an infection that resulted from neutropenia
  • Prevent an infection in people at high risk—this may include people with cancer or immune disorders
White Blood Cell-stimulating Factors

Granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) encourages the body to make more white blood cells.

Removal of Causative Agent

When possible, the toxin or drug that is causing the problems will be removed.

Prevention

You will be monitored if you are taking medication or having medical treatment that could lead to neutropenia. You may be given white blood cell stimulating medications before having treatments. This may prevent neutropenia.

RESOURCES:

American Dental Association
http://www.mouthhealthy.org

National Organization for Rare Disorders, Inc.
http://www.rarediseases.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Boulton F, Cooper C, et al. Neutropenia and agranulocytosis in England and Wales: incidence and risk factors. American Journal of Hepatology. 2003 Apr;72(4):248-54.

Neutropenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 19, 2015. Accessed June 30, 2015.



Last reviewed June 2015 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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