People suffer from neutropenia when they have an abnormally low count of neutrophil cells. These cells are those white blood cells that are used by our body’s immune system to protect us from the bacteria and other such organisms that invade our body. They are produced in our bone marrow and attack the areas of infection by traveling in the bloodstream. Under normal conditions, these cells release chemicals that kill the invading microorganisms.
Symptoms of Neutropenia are not necessarily linked directly to the condition. These can also include the symptoms that come from the underlying diseases that cause Neutropenia. Most often people are not even aware of the problem, unless they get their blood tests for some other purpose.
Infections that do occur as a result of neutropenia usually attack the mucous membranes, like the ones found inside the skin and the mouth.
- Abscesses – collections of pus
- Wounds that take longer to heal
- A fever is another common symptom of such infections.
As the Neutrophil count gets lower, and the Neutropenia persists longer the riskier, it becomes in catching a serious infection.
Neutropenia is relatively uncommon in normal healthy people but it can likely be found in some people of Arabic, African descent or Yemenite Jews. Some causes of Neutropenia are:
- Decreased neutrophils production
- Neutrophils destruction once they are produced
- Collection of neutrophils outside of the circulation.
Neutropenia can also result due to problems mentioned below:
- Infections – viral (most common), bacterial or parasitic, e.g. malaria, Epstein Barr virus (EBV), HIV, tuberculosis
- Vitamin deficiencies such as megaloblastic anemia due to folate or vitamin B12 deficiency
- Medications that can damage bone marrow or neutrophils, such as chemotherapy
- Radiation therapy
- Bone marrow diseases such as myelodysplastic syndrome, leukemias, myelofibrosis, aplastic anemia
- Congenital or inborn disorders of neutrophil production or the bone marrow function, for e.g. Kostmann syndrome.
- Hypersplenism, that is when the spleen destroys the blood cells
- Autoimmune damage to neutrophils (either a prime condition or linked with some other disease, e.g. Felty’s syndrome or from drugs that stimulate the immune system.
Diagnosis is done based on the blood cell count of the blood sample taken from the patient’s vein. Other tests may also be required to determine the cause of Neutropenia owing to a given situation. Sometimes biopsy of the bone marrow is also required.
The Neutropenia patient is treated based on the disease’ underlying causes, severity, symptoms and infections present, and the condition of the patient. The treatment can target the underlying diseases as well as Neutropenia directly. Some direct treatments for Neutropenia include (note:-not all of the underlying treatments are appropriate as per the patient’s condition)
- Monitoring and control of the white blood cells’ growth factors
- Antifungal and/or antibiotic medications for fighting infections
- Granulocyte transfusions
- Intravenous immune globulin or corticosteroid therapy for some immune-mediated neutropenia cases.
Some preventive measures might be implemented in case of Neutropenic patients to minimize the risk of infections. These might include extra care in handwashing, private rooms, or for some patients, use of gowns, gloves, and/or facial masks by the caretakers.