| Neutropenia Classification and external resources |
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| Blood film with a striking absence of neutrophils, leaving only red blood cells and platelets | |
| ICD-10 | D70. |
| ICD-9 | 288.0 |
| DiseasesDB | 8994 |
| eMedicine | med/1640 |
| MeSH | D009503 |
Neutropenia (adjective neutropenic), from Latin prefix neutro- and Greek suffix -πενία (deficiency) is a hematological disorder characterized by an abnormally low number of neutrophil granulocytes (a type of white blood cell). A Blood Film or Peripheral Blood Smear is a slide made from a drop of Blood, that allows the cells to be examined microscopically The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. A prefix is a type of Affix attached to a stem which modifies the meaning of that stem Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly In Grammar, a suffix (also postfix, ending) is an Affix which is placed at the end of a word Hematology ( American English) or haematology ( British English) is the branch of biology (physiology Pathology, Clinical laboratory Neutrophil granulocytes, generally referred to as neutrophils, are the most abundant type of White blood cells in humans and form an essential part of the Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defense against infections by destroying bacteria in the blood. An infection is the detrimental Colonization of a host Organism by a foreign Species. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells such as nutrients and oxygen—and transports Waste products Hence, patients with neutropenia are more susceptible to bacterial infections and without prompt medical attention, the condition may become life-threatening (neutropenic sepsis). Febrile neutropenia is the development of Fever, often with other signs of Infection, in a patient with Neutropenia, an abnormally low number of Neutrophil
Neutropenia can be acute or chronic depending on the duration of the illness. In Medicine, an acute disease is a disease with either or both of a rapid onset a short course (as opposed to a chronic course In Medicine, a chronic disease is a Disease that is long-lasting or recurrent A patient has chronic neutropenia if the condition lasts for longer than 3 months. It is sometimes used interchangeably with the term leukopenia ("deficit in the number of white blood cells"), as neutrophils as the most abundant leukocytes, but neutropenia is more properly considered a subset of leukopenia as a whole. Leukopenia (or leukocytopenia, or leucopenia, from Greek λευκό -white and πενία -deficiency is a decrease in the number of
There are numerous causes of neutropenia that can roughly be divided between either problems in the production of the cells by the bone marrow and destruction of the cells elsewhere in the body. Bone marrow is the flexible tissue found in the hollow interior of Bones In adults marrow in large bones produces new Blood cells It constitutes 4% of Treatment depends on the nature of the cause, and emphasis is placed on the prevention and treatment of infection.
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Classification
There are 3 general guidelines used to classify the severity of neutropenia based on the absolute neutrophil count (ANC) measured in cells per microliter of blood:[1]
- Mild neutropenia (1000 <= ANC < 1500) — minimal risk of infection
- Moderate neutropenia (500 <= ANC < 1000) — moderate risk of infection
- Severe neutropenia (ANC < 500) — severe risk of infection. The litre or liter (see spelling differences) is a unit of Volume.
The abovementioned ranges were developed in Caucasians. In blacks, mild neutropenia is a normal phenomenon, and neutropenia in this population is more properly defined as ANC < 1200. Higher cutoffs may lead to overdiagnosis of neutropenia in the black population. [1]
Signs and symptoms
Neutropenia can go undetected, but is generally discovered when a patient has developed severe infections or sepsis. An infection is the detrimental Colonization of a host Organism by a foreign Species. Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused Some common infections can take an unexpected course in neutropenic patients; formation of pus, for example, can be notably absent, as this requires circulating neutrophil granulocytes. Pus is a whitish-yellow yellow or yellow-brown substance produced during Inflammatory responses of the body that can be found in regions of Pyogenic bacterial
Some common symptoms of neutropenia include:
- Fever
- Frequent infections due to lessened ability to fight bacterial infections
- Mouth ulcers
- Diarrhea
- Burning sensation when urinating
- Unusual redness, pain, or swelling around a wound
- Sore throat
- Shortness of breath
- Shaking chills
Diagnosis
Low neutrophil counts are detected on a full blood count. Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris An infection is the detrimental Colonization of a host Organism by a foreign Species. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have Ulcers are healing wounds that develop on the skin mucous membranes or eye In Medicine, diarrhea, also spelled diarrhoea (see spelling differences) is frequent loose or liquid Bowel movements Acute diarrhea In Medicine, specifically Urology, dysuria refers to painful Urination. See also Strep throat. Pharyngitis (ˌfarɪnˈdʒʌɪtɪs is in most cases a Painful inflammation of the Pharynx, and is Dyspnea or dyspnoea (pronounced disp-nee-ah, IPA /dɪsp'niə/ from Latin dyspnoea, from Greek dyspnoia from Rigor is a shaking occurring during a high Fever. It occurs because cytokines and Prostaglandins are released as part of an Immune A complete blood count ( CBC) also known as full blood count ( FBC) or full blood exam ( FBE) or blood panel, is Generally, some other investigations are required to arrive at the right diagnosis. When the diagnosis is uncertain, or serious causes are suspected, bone marrow biopsy is often necessary. Bone marrow examination refers to the pathologic analysis of samples of Bone marrow obtained by bone marrow biopsy (often called a Trephine biopsy
Other investigations commonly performed: serial neutophil counts for suspected cyclic neutropenia, tests for antineutrophil antibodies, autoantibody screen and investigations for systemic lupus erythematosus, vitamin B12 and folate assays and acidified serum (Ham's) test. Cyclic neutropenia (or cyclical neutropenia) is a form of Neutropenia which tends to occur every three weeks and lasting three to six days at a time due to changing An autoantibody is an Antibody (a type of Protein) manufactured by the Immune system that is directed against one or more of the individual's own proteins Systemic lupus erythematosus ( SLE or lupus,) is a chronic autoimmune disease that can be fatal though with recent medical advances fatalities are becoming Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 [2]
Causes
Causes can be divided into the following groups:
- Decreased production in the bone marrow:
- hereditary disorders (e. Bone marrow is the flexible tissue found in the hollow interior of Bones In adults marrow in large bones produces new Blood cells It constitutes 4% of A genetic disorder is a condition caused by abnormalities in Genes or Chromosomes While some diseases such as Cancer, are due to genetic abnormalities acquired g. congenital neutropenia, cyclic neutropenia)
- cancer
- certain medications
- radiation
- Vitamin B12 or folate deficiency. Cyclic neutropenia (or cyclical neutropenia) is a form of Neutropenia which tends to occur every three weeks and lasting three to six days at a time due to changing Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Radiation, as in Physics, is Energy in the form of waves or moving Subatomic particles emitted by an atom or other body as it changes from a higher energy Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9
- Increased destruction:
- aplastic anemia
- autoimmune neutropenia. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues
- chemotherapy
- Marginalisation and sequestration:
There is often a mild neutropenia in viral infections. Chemotherapy, in its most general sense refers to treatment of disease by chemicals that kill cells specifically those of micro-organisms or Cancer. In Medicine, dialysis (from Greek "dialusis" meaning dissolution "dia" meaning through and "lusis" meaning loosening is primarily An infection is the detrimental Colonization of a host Organism by a foreign Species.
Therapy
There is no ideal therapy for neutropenia, but recombinant G-CSF (granulocyte-colony stimulating factor) can be effective in chemotherapy patients, in patients with congenital forms of neutropenia including severe congenital neutropenia, autosomal recessive Kostmann's syndrome, cyclic neutropenia, and myelokathexis. Granulocyte colony-stimulating factor ( G-CSF or GCSF) is a Colony-stimulating factor hormone
History
The relationship between a low neutrophil count and increased risk of infection was first demonstrated in patients with leukemia. Leukemia or leukaemia (Greek leukos λευκός, "white" aima αίμα, "blood" is a Cancer of the Blood [3]
See also
- Aplastic anemia
- Pancytopenia
- Thrombocytopenia
References
- ^ a b Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP (2007). Pancytopenia is a medical condition in which there is a reduction in the number of red and White blood cells as well as Platelets Thrombocytopenia (or -paenia, or thrombopenia in short is the presence of relatively few Platelets in Blood. "Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences". Ann. Intern. Med. 146 (7): 486-92. PMID 17404350.
- ^ Levene, Malcolm I. ; Lewis, S. M. ; Bain, Barbara J. ; Imelda Bates. Dacie & Lewis Practical Haematology. London: W B Saunders, 586. ISBN 0-443-06377-X.
- ^ Bodey GP, Buckley M, Sathe YS, Freireich EJ (1966). "Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia". Ann. Intern. Med. 64 (2): 328–40. PMID 5216294.
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