Neutropenia is a health condition in which the number of neutrophils in the bloodstream is low and leaves a person susceptible to dangerous infections. People with severe and prolonged neutropenia are faced with a life-threatening inability to fight infections.
Definition & Facts
The neutrophils help the body fight infection by destroying harmful bacteria that attack the body. It is the body’s primary defense against infections and represents about 45 percent to 75 percent of all the white blood cells in the blood. When this amount is reduced, the body’s capacity to repel infections is greatly affected, and the patient becomes more vulnerable to infections.
If the amount of neutrophils for an adult is lower than 1,500 neutrophils per microliter of blood, it may be considered neutropenia. It is a common condition or a side effect that occurs in people with cancer who are undergoing chemotherapy or radiation therapy. People with cancer usually end up having a reduced capacity to fight infection after undergoing chemotherapy.
Symptoms & Complaints
- A fever of 100.5 degrees Fahrenheit (38.06 degrees Celsius) or higher
- A toothache
- Abdominal pains
- Changes in mental state
- Chills and/or sweating
- Diarrhea and/or vomiting
- Flu-like symptoms
- Frequent urination
- Painful urination
- Low blood pressure (hypotension)
- Mucositis which is painful inflammation and ulceration of the gastrointestinal tract
- Pain near the anus or sores around the anus
- Pain, redness, or swelling, particularly around a cut or wound
- Sore throat
- Shortness of breath
- Sores in the mouth
- Unusual vaginal discharge
Patients who are aware that they have neutropenia should inform their doctors as soon as they experience any of the symptoms. For them, even a slight infection can quickly develop into something serious. Patients with cyclic neutropenia can have recurring symptoms based on the rise and fall of their neutrophil cell count.
Though the causes of some cases may be unknown or idiopathic, neutropenia can be caused by one or more of the following:
- Alcohol abuse
- An obstruction in the production of neutrophils in the bone marrow
- Autoimmune diseases such as Crohn's disease, rheumatoid arthritis, and lupus
- Blood pressure drugs
- Congenital disorders causing low production of neutrophils or failure of neutrophils to enter the bloodstream
- Dengue fever
- Epilepsy drugs
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hypersplenism, which is a condition in which there is abnormal blood cell destruction in the spleen
- Leukemia and other conditions affecting the bone marrow
- Lyme disease
- Nutritional deficiency
- Psychiatric drugs
- Radiation exposure
- Rare hereditary diseases
- Salmonella infection
- Viral infections in general
While there are many possible causes of neutropenia, the most common cause of neutropenia is likely chemotherapy. After chemotherapy, people with neutropenia become vulnerable to all types of infections while waiting to recover from their low neutrophil cell count.
Chemotherapy uses drugs to destroy cells that grow rapidly, like cancer cells. Unfortunately, blood cells in the bone marrow, cells in the hair follicles, or cells in the mouth and intestines also grow rapidly and get destroyed by the chemotherapy together with the cancer cells.
Diagnosis & Tests
Diagnosing neutropenia is difficult because it is a very rare condition. Often, its symptoms are confused with other diseases or ailments. Misdiagnosis is common, and it is sometimes discovered during routine blood tests or tests for a different condition. Patients undergoing chemotherapy must undergo regular blood tests, and neutropenia is often detected during these.
In order to establish neutropenia, a physician will need a complete blood count (CBC) which directly measures the neutrophil count. A bone marrow examination is also likely to be a part of the diagnostic process. This requires a bone marrow biopsy in which a sample of bone marrow is removed from the patient via fine-needle aspiration while the patient is under sedation. This can help rule out aplastic anemia and cancers of the bone marrow.
Treatment & Therapy
The treatment of neutropenia depends on the causes and severity of the disorder and can include drugs that will speed up the body's production of neutrophils. Treatment may involve the following:
- Administration of antibiotics for bacterial infections
- Changing or discontinuing medications in cases of drug-induced neutropenia
- Granulocyte or white blood cell transfusion
- Stem-cell transplants may also be used to cure serious neutropenia as well as other bone marrow-caused problems.
Prevention & Prophylaxis
- Observing good personal hygiene and dental hygiene
- Avoiding contact with crowds and with people who are not well
- Always wearing shoes
- Cleaning cuts and wounds right away and keeping them bandaged
- Avoiding unpasteurized dairy foods, undercooked meat, raw fruits and vegetables
- Staying out of public hot tubs, ponds, and rivers
- Wearing gloves when gardening
- Not sharing personal items with others
- Staying up-to-date on vaccinations such as flu shots.
To the extent that neutropenia may be caused by HIV and other sexually transmitted diseases, practicing safe sex may reduce the risk of developing this condition. Cancer patients who will undergo chemotherapy should discuss their risk of neutropenia with their doctor.