Neutropenia

Overview

Neutropenia is a medical condition that occurs when you have lower than normal neutrophils (a type of white blood cells) in your bloodstream. It can make you susceptible to infections. In severe cases of neutropenia, the normal bacteria present in your mouth and digestive tract can also cause infections .

What is Neutropenia?

Neutrophils are cells in the immune system that attack bacteria as well as other organisms when they invade our body.

Neutrophils, a type of white blood cell, are created by your bone marrow. These neutrophils then travel in your bloodstream and move to areas of infection where they ingest and then neutralize the offending bacteria. When the count of neutrophils drops in your blood, you develop neutropenia. 

Depending on the number of neutrophils in your bloodstream, neutropenia can be classified as mild, moderate, or severe.

• Mild neutropenia cases contain 1,000 – 1,500 neutrophils per microliter of blood.
• Moderate neutropenia cases contain 500 – 1,000 neutrophils per microliter of blood.
• Severe neutropenia cases contain less than 500 neutrophils per microliter of blood.

Further, neutropenia can also be classified into the following

• Acute Neutropenia 

Also known as temporary or short-lasting neutropenia, it can be well tolerated and often normalizes quickly.

• Chronic Neutropenia

It is a much more severe type of neutropenia that lasts for a period of two months or more.

• Congenital Neutropenia

This type is with which infants are born.

• Acquired Neutropenia

In this type, people develop neutropenia throughout their lives. Examples include side effects from chemotherapy or due to certain infections.

What are the Symptoms of Neutropenia?

Neutropenia does not cause any visible symptoms as such. In most cases, people are diagnosed with neutropenia only when they have a blood test for a completely different reason. More commonly, neutropenia is seen in people who undergo chemotherapy for cancer treatment.

In some cases, infections can occur as a complication of neutropenia. More often, these infections occur in the mucous membranes, such as the skin or the inside of the mouth. The infection can occur in the form of:

• Rashes.
• Ulcers.
• Wounds that take a long time to heal.
• An abscess (also known as a collection of pus).

When Should You Visit a Doctor?

Mild neutropenia does not cause any visible symptoms. However, with severe neutropenia, you can experience the following:

• Abscesses
• Ulcers 
• Fever
• Repeated infections

If you experience any of these symptoms for a prolonged period, consult with a doctor. 

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Causes of Neutropenia

Neutropenia occurs due to one of the following reasons:

• The neutrophils in your bloodstream are destroyed or used up faster than they are produced.
• The bone marrow does not make a sufficient amount of neutrophils in the first place.

Several factors can fall into these two categories of causes, which include:

• Medications, including chemotherapy, one of the most common causes of neutropenia.
• Certain infections such as sepsis, tuberculosis, or hepatitis.
• Autoimmune disorders such as lupus, Crohn’s disease, or rheumatoid arthritis.
• Vitamins or minerals deficiencies such as vitamin B12, copper, or folate.
• Bone marrow or blood-related disorders.

How is Neutropenia Diagnosed?

Your doctor will run a simple blood test, also known as a complete blood count, to diagnose neutropenia. The blood test will reveal the count of neutrophils in your bloodstream. If needed, in severe cases, your doctor may also test your bone marrow.

If a single blood test shows you have lower levels of neutrophils in your blood, it may not necessarily mean you have neutropenia. To confirm the diagnosis, repeated blood tests are needed. 

What are the Treatment Options Available for Neutropenia?

The doctor will consider several factors, including the causes and severity of your neutropenia, before devising a treatment plan. If you have mild neutropenia, you may not need any medical treatment. 

The standard treatment options include:

• If you develop neutropenic fever, the doctor may prescribe antibiotics for its treatment. 
• The doctor may prescribe treatment with granulocyte colony-stimulating factor (G-CSF). It will help stimulate the bone marrow to produce more neutrophils. This procedure is used to treat several types of neutropenia and has proven to be lifesaving in many cases. 
• Although very uncommon, the doctor may perform granulocyte transfusion, also known as white blood cell transfusion.
• In neutropenia caused by bone marrow failure, the doctor may perform a stem cell transplant. However, it is also prescribed in some types of severe neutropenia.
• If your neutropenia is caused due to medications, the doctor may prescribe alternative medications to help prevent your neutrophil count from dropping.

Can Neutropenia be prevented?

Although it is not entirely possible to prevent neutropenia, you can still take precautionary measures to avoid the risk of infections, if you have neutropenia . These include:

• Maintain good hygiene. Wash your hands frequently and get a dental checkup regularly.
• Avoid coming in contact with sick people.
• Avoid consuming undercooked meat, unpasteurized dairy foods, and raw fruits and vegetables without washing them properly.
• If you get injured, clean your wounds thoroughly and then cover them with a clean bandage.

Conclusion

Neutropenia does not cause any symptoms as such. So if you experience fever, diarrhea, and sores for a prolonged time along with repeated infections, immediately consult with a doctor. Since there are treatment options available for neutropenia, the outlook is good for most patients. An early diagnosis and treatment plan can help treat the neutropenia.

Frequently Asked Questions (FAQs) 

Who is affected by neutropenia?

Neutropenia can affect people of all age groups. In some people, it can occur due to an infection. In others, it can occur as a side effect of chemotherapy done to treat cancer. It is estimated that approximately 50 percent of the people who undergo chemotherapy develop mild neutropenia.

Is neutropenia deadly?

People suffering from neutropenia have an increased risk of developing infections. Since the count of neutrophils, the type of white blood cells that helps fight infections, is relatively lower in people with neutropenia, their tendency to develop infections increases. The infections, if not treated on time, can prove deadly. 

Does neutropenia go away?

In most cases, neutropenia is often mild, and it resolves with prevention and treatment measures. However, some people suffer from chronic neutropenia that lasts for almost two months. This type of neutropenia may or may not go away with time and can remain a life-long medical condition.

What is an ideal neutropenia diet?

A neutropenic diet helps people with a weakened immune system. Neutropenic diet involves picking up foods and preparing them in a way which lowers your risk of foodborne sickness. If you have a weak immune system, your physician may suggest you to follow a neutropenic diet to limit your exposure to harmful bacteria and microbes.

Here are some foods and drinks you can incorporate into your diet to ensure you stay protected from harmful bacteria and organisms:

Can neutropenia turn into leukemia?

In severe cases, such as chronic neutropenia, the neutrophil count in the bloodstream drops below 500 neutrophils per microliter of blood. This indicates that the body becomes more susceptible to developing infections. Some patients with chronic neutropenia tend to be at a greater risk of developing leukemia too.