What Is Neutropenia?
Neutropenia is a condition wherein the body has a low rate of neutrophils, or neutrophil granulocytes. Neutrophils is a type of white blood cells. This composes 50 to 70 percent of the white blood cells in the entire body.
Neutrophils are the first defense line up for the body. They are responsible in protecting and fighting against the bacteria that could possibly enter the body. People having this condition is more prone to several infections- viral or bacterial, and could cause Neutropenic Sepsis- a life-threatening disease, if not given prompt treatment.
This is caused if the white blood cells in the body are destroyed. The cause of this sickness is similar to Autoimmune Neutropenia, aplastic anemia and these could be triggered by hemodialysis or chemotherapy treatments. In some cases, mild Neutropenia could also occur among persons who have contracted a viral infection.
Neutropenia can also be due to the inability of the bone marrow to produce neutrophils. This happens among people lacking in Vitamin B12 or folic acid, as well as to those who have cancer, Congenital Neutropenia (a hereditary type of neutropenia), pesticide exposure, or those who ae exposed in radiation.
Who Is At Risk?
Neutropenia is a rare disease. About one in every 100,000 persons could have it. Females are more prone to this disease, and so with the elderly. Once diagnosed of this disease, prompt medical attention should be given to avoid other complications due to fungi, bacteria, virus or all of the three combined.
1. Cyclic Neutropenia- a type of neutropenia occurring every 21 days.
2. Congenital Neutropenia- the most common, and could be inherited to the offspring.
3. Idiopathic Neutropenia- cause yet unknown
4. Isoimmune Neonatal Neutropenia- a type of neutropenia common to newborn babies.
There could be clear evidences of infection in the mouth, throat, lungs, skin and sinuses because of the lack of protection from the white blood cells. The patient will have frequent fever, mouth or anal sores, infection in the ear, gums, throat, and tonsils, abscesses, and periodontal disease. In cases where neutropenia becomes severe, sepsis or other hazardous infections take place.
Patients having this disease could also experience chills, difficulty in urinating due to uncomfortable, painful or burning sensation, shortness of breath, diarrhea, and swelling in various parts of the body.
Those with Acute neutropenia could have symptoms in as fast as few hours or days. Chronic neutropenia patients on the other hand develop the disease at a very gradual pace that could reach for years. Less or no symptoms are seen until infection takes place in any of the patient’s body.
A complete blood count will help determine neutrophil granulocyte count. Aside from that, the patient will undergo a thorough examination to determine other complications that could be caused by neutropenia. Biopsy or aspiration of the bone marrow might also be done to the suspected patient.
The doctor takes a bone marrow sample from the patient and taking a close look on it under the microscope. A patient who has neutropenia has an impaired production of neutrophil which could be visible under a microscope. This test will also determine any infections, or defects in the marrow.
It is also recommended that suspected patients undergo other tests such as Sputum Gram stain and culture, urinalysis, RBC folate levels, serum Vitamin B12, and blood culture tests.
Patients who are diagnosed with neutropenia should also have their chests examined both posteriorly and anteriorly to check if the patient is possibly affected with pneumonia.
The severity of Neutropenia will depend on the neutrophil count. Normal neutrophil levels ranges between 1,500 to 7,000 neutrophils per mm3. Children has a lower count, particularly children below 7 years old. Anything lower than 1,500 to 7,000 for adults would be diagnosed as mild neutropenia. Those having between 500 to 1,000 per mm3 of absolute neutrophil count or ANC has moderate neutropenia. Severe neutroperia would be below 500 per mm3.
Patients should observe proper hygiene, and cleanliness of surroundings. They should also avoid public places, as this is a very good venue for all kinds of viruses, bacteria and germs. Patients are also recommended to wear sunscreen when going out and be ore particular with oral hygiene. Sports that may result in injuries should also be avoided, as well as usage of tampons, rectal suppositories or sexual intercourse. Neutropenia is not contagious, but complications alongside this disease might be, so it is better not to get close to other people especially if there are other complications to avoid others getting infected.
Treatment for neutropenia depends on the severity and the cause of acquisition. Those with infections would be given antibiotics, and other medications would be given for other complications.
Patients who had Neutropenia due to chemotherapy would be given sargramostin (Leukine, Prokin). This medication stimulates white blood cell production. Neutropenia induced by pesticide would be easier to treat- the patient will be removed from such environment.
B-complex, folic acid and vitamin supplements will be given to those who had neutropenia due to nutritional deficiency. Patients will also be encouraged to eat green leafy vegetables and other foods rich in folic acid and vitamin B complex.
Other treatments include the following: spleen removal (for those suffering Felty’s syndrome), creams and ointments for abrasions and wounds, stool softeners for constipation, colony-stimulating growth supplements for increased production of white blood cells, Corticosteroid treatment, stem cell transplant, Antithymocyte globulin and many others.
Acupuncture is said to be helpful among women with Neutropenia, particularly those who acquired it because of chemotherapy treatments for ovarian cancer.
Currently, scientists are looking for more alternative treatments. Medications such as pegylated interferon, ribavirin, ganulocyte colony-stimulator, erthropoietin or combination of all could aid in anemia or neutropenia prevention for those undergoing anti-hepatitis C therapy.
Neutropenia is curable, however, this will depend on the severity of the of the disease. Normally, serious complications take place by 21% probability. Recovery is even faster if the sickness is diagnosed and treated early. Cancer patients having neutropenia because of various treatments destructive to the white blood cells have a mortality rate of 4 to 30%.