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Neutropenia is a reduction in the number of neutrophils (neutrophils) in the peripheral blood below normal. The decrease in their number is associated with a high risk of severe infections. Neutrophils are classified as white blood cells, which are mainly responsible for maintaining the body’s immunity. There may be many different causes for the onset of neutropenia. It can be generally divided into congenital neutropenia (caused by genetic factors) and acquired neutropenia.
Neutropenia – definition and types
Neutropenia can be diagnosed when the amount of neutrophils in the blood is less than 1500 / µl. There are 3 types of this disease:
- mild neutropenia – the number of neutrophils below 1500 / µl,
- moderate neutropenia – number of neutrophils between 500-1000 / µl,
- severe neutropenia – number of neutrophils less than 500 / µl.
Neutropenia affects children, adults and the elderly.
Neutropenia in children and infants
Neutropenia in children and infants, it is often manifested by infections around the anus and the formation of abscesses in the ischio-rectal fossa. The most common factor initiating infection is the bacterium – staphylococcus aureus. At the time of any illness associated with fever, consultation with the attending physician should be performed by children suffering from neutropenia in order to determine further management. It is recommended to follow the current vaccination schedule if the disease is not associated with immunodeficiency syndrome. Proper skin care, including cleaning abrasions or cuts after breaking its continuity, will help prevent local infections. It is important to maintain a high degree of hygiene. Children with mild to moderate neutropenia do not need to be completely isolated. Indications for strict isolation apply only to children with severe neutropenia or severe infections running in parallel with neutropenia.
Neutropenia – causes
Do neutropenia they can lead to abnormalities in the production of neutrophils in the marrow or various disorders in which there is an excessive and premature destruction of neutrophils in the body. Neutropenia it can also occur due to the presence of congenital disease entities (e.g. Barth syndrome, bone marrow failure syndromes).
Very often, a drastic reduction in the number of neutrophils leading to neutropenia appears in connection with:
- plastic anemia,
- bone marrow infiltration (tuberculosis, leukemia and other cancers),
- deficiency of vitamin B12 or / and folic acid,
- a severe infection (flu, rubella, Epstein-Barr or HIV infection, chicken pox and some bacterial infections)
- myelodysplastic syndrome,
- irradiation,
- taking certain medications (certain cytostatics, antithyroid drugs, antiepileptic drugs, antibiotics, painkillers),
- enlargement and excessive work of the spleen,
- autoimmune diseases,
- after dialysis or operations with blood filtering machines.
Post-chemotherapy neutropenia
It becomes a more and more common problem neutropenia caused by anti-cancer treatment. The production of leukocytes and their defense functions are often impaired by the strong action of cytostatics, radiation and immunosuppressive therapy. Treatment damages not only cancer cells, but also healthy cells, leading to their dysfunction. Accordingly, it can develop neutropenia. Symptoms may be more pronounced, the more intensive the oncological therapy and the more severe the bone marrow failure due to the underlying neoplastic disease. Neutropenia after chemotherapy, i.e. a decrease in the level of neutrophils and the accompanying infections, is one of the basic problems in the treatment of oncological patients. Neutropenia after chemotherapy, it may be asymptomatic or be accompanied by a symptomatic infection.