What is Neutropenia?

Those with the blood disorder neutropenia have low levels of white blood cells (WBCs) called neutrophils. These neutrophils are a very special kind of white blood cell and they make up any where from 50 to 70% of the total number of white blood cells in your body. These special WBCs are your body’s first line of defense against infections. The cause of the disorder can be medications or various diseases such as HIV/AIDS.

Signs and Effects

Those who have this blood disorder are more likely to develop infections that are bacterial. The signs that one would normally expect to see in a patient will be absent though because the RBCs that cause the redness at the site of infection will be missing.

Without these typical signs of infection like redness at the site, medical personnel like dentist may miss the early signs of gum infections and the infection can become worse before it is noticed. This is why it is important for individuals who have neutropenia to have it noted in all medical and dental records.

Usually when the dentist knows the patient has neutropenia, an antibiotic will be given prior to any dental work and usually the antibiotic is continued for several days afterwards too.

Neutropenic sepsis is a serious life-threatening infection that has gone undetected because of the condition. If the person has neutropenia for longer than 3 months it is said to be a chronic condition.

Diagnosing Neutropenia

An individual with neutropenia has a problem with the production of the cells in the bone marrow and perhaps destruction of the cells elsewhere in his/her body. The doctor treating the individual will determine the cause and design the treatment accordingly.

The signs or symptoms include fever, frequent infections including the inability to fight off bacterial infections. The individual typically has mouth ulcers, diarrhea, and perhaps a burning sensation when urinating. Other symptoms may include a sore throat, shortness of breath, and chills.

A doctor can arrive at a diagnosis by ordering a full blood count. Occasionally the doctor may want to rule out other possible diagnosis’s or conduct a bone marrow biopsy to be sure of neutropenia.

The doctor may also order tests such as a serial neutrophil count, antineutrophil antibodies, an autoantibody screen and screenings for lupus erythematosus, and may also do vitamin B12 and folate assays or a acidified serum (Ham’s) test.

What Causes Neutropenia?

There can be different causes for neutropenia that include a decreased production in the bone marrow such as when aplastic anemia is present, blood cancers, certain medications can cause a decrease in bone marrow production, and also certain hereditary disorders can contribute to this too including cyclic neutropenia, and congenital neutropenia. If the patient had radiation treatment that can be a cause or if they suffer from Vitamin B12 or a folate deficiency.

Other causes are a increased in white blood cell destruction such as what might occur from a autoimmune neutropenia, or when chemotherapy treatments are given. Hemodialysis can also cause the condition. Sometime a person can contract a mild neutropenia when they have a viral infection.

Image: David Gregory & Debbie Marshall, Wellcome Images

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