What is neutropenia?
Neutropenia is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell. They are created by bone marrow, travel in your bloodstream and move to areas of infection. They release chemicals to kill invading microorganisms, and are very important in fighting off infections — particularly those caused by bacteria.
For adults, counts of less than 1,500 neutrophils per microliter of blood are considered to be neutropenia. For children, the cell count indicating neutropenia varies with age.
Some people have lower-than-average neutrophil counts, but not an increased risk of infection. In these situations, their neutropenia is not a concern. Neutrophil counts less than 1,000 neutrophils per microliter — and especially counts of less than 500 neutrophils per microliter — are always considered to be neutropenia, where even the normal bacteria from your mouth and digestive tract can cause serious infections.
There are 4 types of neutropenia:
- Congenital: Congenital neutropenia is presented at birth. Severe congenital neutropenia is also called Kostmann syndrome. It causes very low neutrophil levels. In some cases, neutrophils are absent. This puts infants and young children at risk for serious infections.
- Cyclic: Cyclic neutropenia is present at birth. Cyclic neutropenia causes neutrophil counts to vary in a 21-day cycle. Neutrophil counts fall from normal to low. A period of neutropenia may last a few days. Normal levels follow for the rest of the cycle. After that, the cycle resets and begins again.
- Autoimmune: In autoimmune neutropenia, your body makes antibodies that fight your neutrophils. These antibodies kill the neutrophils, and this causes neutropenia. Autoimmune neutropenia develops later in life.
- Idiopathic: Idiopathic neutropenia develops any time in life and can affect anyone. The cause is unidentified.
How common is neutropenia?
This neutropenia can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of neutropenia?
Neutropenia itself often does not cause symptoms. In some cases, people only learn they have neutropenia when they have a blood test for an unrelated reason. However, people may have other symptoms from infection or the underlying problem causing the neutropenia.
Infections can occur as a complication of neutropenia. They occur most often in the mucous membranes, such as the inside of the mouth and the skin.
These infections can appear as:
- Abscesses (collections of pus);
- Wounds that take a long time to heal;
- Fever is also a common symptom of infection.
The risk for serious infection generally increases as:
- Neutrophil count goes down.
- Duration of severe neutropenia gets longer.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always effective to discuss with your doctor about your situations.
What causes neutropenia?
The causes of neutropenia include:
- Problem in the production of neutrophils in the bone marrow;
- Destruction of neutrophils outside the bone marrow;
- Nutritional deficiency.
Causes of decreased production of neutrophils include:
- Being born with a problem with bone marrow production (congenital).
- Leukemia and other conditions that affect the bone marrow or lead to bone marrow failure;
Infections that can cause neutropenia include:
- Dengue fever;
- Viral infections such as Epstein-Barr virus, cytomegalovirus, HIV, viral hepatitis;
Upward destruction of neutrophils can be due to the body’s immune system targeting neutrophils for destruction. This may be related to having an autoimmune condition, such as:
- Crohn’s disease;
- Rheumatoid arthritis;
In some people, neutropenia can be caused by certain medications, such as:
- Blood pressure drugs;
- Psychiatric drugs;
- Epilepsy drugs.
What increases your risk for Neutropenia?
There are many risk factors for Neutropenia, such as:
- a weakened immune system;
- under chemotherapy and radiation therapy;
- people who are 70 years old or older are at higher risk.
Diagnosis & treatment
The information provided is not a substitution for any medical advice. ALWAYS consult with your doctor for more information.
How is neutropenia diagnosed?
Your doctor can use these tests to diagnose neutropenia:
- A complete blood count (CBC) measures neutrophil counts.
- Intermittent CBC tests can help your doctor check for changes in neutrophil count three times per week for six weeks.
- An antibody blood test checks for autoimmune neutropenia;
- Your doctor can use bone marrow aspirate to test bone marrow cells.
- A bone marrow trephine biopsy tests a piece of the bony part of bone marrow.
- Cytogenetic and molecular testing study the structures of cells.
How is neutropenia treated?
When deciding on treatment, health care providers consider the cause and severity of the neutropenia. Mild cases may not need any treatment. In many cases, neutropenia goes away on its own as the bone marrow recovers and begins to produce enough white blood cells.
Approaches for treating neutropenia include:
- Antibiotics for bacterial infections, if the underlying cause is an infection.
- A treatment called granulocyte colony-stimulating factor (G-CSF). This stimulates the bone marrow to produce more white blood cells. It is used for several types of neutropenia, including congenital types. This treatment can be lifesaving in these cases.
- Changing medications, if possible, in cases of drug-induced neutropenia.
- Granulocyte (white blood cell) transfusion.
- Stem cell transplants may be useful in treating some types of severe neutropenia, including those caused by bone marrow problems.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage Neutropenia?
The following lifestyles and home remedies might help you cope with Neutropenia:
- Maintaining good oral hygiene, getting regular dental exams, and use an antibacterial mouthwash.
- Keep vaccinations current.
- Get medical care for a fever above 101.3°F (38.5°C).
- Wash your hands thoroughly.
- Care for cuts and scrapes.
- Using antibiotics and antifungals as directed;
- Know how to reach your doctor and hospital;
- Talk to your doctor before foreign travel.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Neutropenia – infants. https://medlineplus.gov/ency/article/007230.htm. Accessed October 10, 2016.
http://www.healthline.com/health/neutropenia#Overview1. Accessed October 10, 2016.
http://www.webmd.com/a-to-z-guides/neutropenia-causes-symptoms-treatment#1. Accessed October 10, 2016.
Neutropenia (low neutrophil count). http://www.mayoclinic.org/symptoms/neutropenia/basics/causes/sym-20050854. Accessed October 10, 2016.
Review Date: January 4, 2017 | Last Modified: January 4, 2017