Neutropenia (low neutrophil count)

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Definition

Neutropenia (noo-troe-PEE-nee-uh) is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell important to fighting off infections — particularly those caused by bacteria.

For adults, counts of less than 1,500 neutrophils per microliter of blood are considered to be neutropenia. For children, the cell count indicating neutropenia varies with age.

Some people have lower-than-average neutrophil counts, but not an increased risk of infection. In these situations their neutropenia isn’t a concern. Neutrophil counts less than 1,000 neutrophils per microliter and especially counts of less than 500 neutrophils per microliter — are always considered to be neutropenia, where even the normal bacteria from your mouth and digestive tract can cause serious infections.

Causes

Cancer chemotherapy is probably the most common cause of neutropenia. People with chemotherapy-related neutropenia are prone to infections while they wait for their cell counts to recover.

Neutrophils are manufactured in bone marrow — the spongy tissue inside some of your larger bones. Anything that disrupts neutrophil production can result in neutropenia.

Specific causes include:

  • Kostmann’s syndrome a congenital disorder involving low production of neutrophils
  • Myelokathexis a congenital disorder involving failure of neutrophils to enter the bloodstream
  • Leukemia
  • Myelodysplastic syndromes
  • Myelofibrosis
  • Chemotherapy
  • Alcohol use disorder
  • Chronic idiopathic neutropenia in adults
  • Vitamin deficiencies

Certain infections also can result in neutropenia, including:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • HIV/AIDS
  • Lyme disease
  • Malaria
  • Salmonella infection
  • Sepsis — an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced
  • Other viral infections that disrupt the work of bone marrow

Conditions that destroy neutrophils in the bloodstream and that can result in neutropenia include:

  • Rheumatoid arthritis and other autoimmune disorders
  • Medications, such as antibiotics
  • Hypersplenism an abnormality of the spleen causing blood cell destruction

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