A. What Is Neutropenia?
Neutropenia is a decreased number of neutrophils in the blood. Neutrophils are a type
of white blood cell (WBC). Together, the WBCs are responsible for the immune response, the
fighting of infection. There are many different kinds of WBCs, each with their own
particular action. The neutrophils function by leaving the blood to destroy bacteria and
fungi in the cells. Without enough neutrophils to fight these invading cells, infection
results. Neutrophils are produced in the bone marrow and removed from the blood by the
spleen. Therefore, blood levels can be low because of insufficient production in the
marrow, excessive destruction in the blood or cells, or increased removal from the blood
by the spleen.
B. Causes
Neutropenia can result from severe bacterial infections, protozoal infections such as
malaria or typhoid fever, or viral infections (such as HIV, hepatitis, measles). In
addition, it can be caused by disease of the spleen, bone marrow tumors or diseases such
as leukemia, agranulocytosis,
and aplastic anemia, rheumatoid
arthritis, and systematic lupus erythematosus
(SLE). Drugs and chemicals that may cause neutropenia include
penicillin (Bicillin) and those
used in cancer chemotherapy. Ionizing radiation used in cancer therapy and folic acid deficiency or vitamin
B12 deficiency may also cause neutropenia. In addition, neutropenia may be
related to alcoholism.
C. Symptoms
Neutropenia may be accompanied by a fever, easy bruisability, petechiae (small
red-purple spots on skin), enlarged glands in the throat, and an enlarged spleen. In
addition, the patient shows signs of infection. Neutropenia is often accompanied by anemia
and thrombocytopenia, causing weakness, pallor, and bleeding. Please see Anemia
and Thrombocytopenia.
D. Diagnosis
Neutropenia is diagnosed by patient history, physical examination for symptoms, and
laboratory testing. Diagnosis usually involves blood testing and may require bone marrow
sampling to determine the cause of the problem.
E. Treatment
The primary treatment for neutropenia is to address the underlying cause of the
problem. This may involve administration of vitamin supplements, medication, transfusion,
or growth factors.