Neutropenia involves:
Decreased Neutrophil Production: Due to bone marrow suppression from conditions like leukemia, myelodysplastic syndromes, or aplastic anemia.
Increased Neutrophil Destruction: Autoimmune disorders such as lupus or certain medications can cause immune-mediated destruction of neutrophils.
Chemotherapy or Radiation Therapy: Suppresses bone marrow function, leading to decreased neutrophil production.
Infections: Viruses like HIV or hepatitis can directly infect bone marrow cells, reducing neutrophil production.
Clinical Evaluation
Symptoms: Assessment for signs of infection such as fever, chills, sore throat, and unusual or recurrent infections.
Physical Examination: Examination findings may include signs of systemic infection and signs of mucosal or skin infections.
Complete Blood Count (CBC): Essential to determine absolute neutrophil count (ANC), categorizing neutropenia as mild, moderate, or severe.
Bone Marrow Biopsy: May be performed to identify the cause of neutropenia and evaluate bone marrow function.
Increased susceptibility to infections, particularly bacterial and fungal.
Fever, often the first sign of infection in neutropenic patients.
Oral ulcers, sore throat, or other mucosal lesions.
Skin infections such as cellulitis or abscesses.
Pneumonia or other respiratory infections in severe cases.
Management aims to:
Treat Underlying Cause: Address the primary condition or discontinue offending medications.
Antibiotic Therapy: Prophylactic or therapeutic antibiotics to prevent or treat infections.
Granulocyte Colony-Stimulating Factor (G-CSF): Stimulate neutrophil production in severe neutropenia.
Intravenous Immunoglobulin (IVIG): Used in autoimmune neutropenia or severe infections.
Infection Prevention: Including hygiene measures and avoiding exposure to potential sources of infection.