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Neutropenia

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Did you know that not all white blood cells (leukocytes) are created equal? A special type of white blood cell, neutrophils (polymorphonuclear leukocytes or PMNs), dominate the white blood cell scene.

Neutrophils are manufactured in the bone marrow and the majority of all white blood cells in your body consist of neutrophils. According to Mayo Clinic, neutrophils account for 45 – 70 percent of all white blood cells.

White blood cells are commissioned with the wonderful job of protecting your body against various types of infection and diseases. Within that scope, neutrophils perform a very specific function – protection against fungi and bacterial infections. Persons with Neutropenia may find themselves more susceptible to skin (Staphylococcus aureaus), gastrointestinal, urinary tract or fungal infections. These infections are not limited to the surface of the skin only but may well spread to the lungs and other internal organs.

Neutropenia occurs when your levels of neutrophils drop below “normal” or the absolute neutrophils count (ANC), leaving you more vulnerable to bacterial and fungi infections. What are considered normal levels may vary somewhat depending on the age of the patient or the medical discipline.

There is some disagreement about the actual neutrophils level that should be used for the ANC. Mayo Clinic defines the ANC at 1700 per microliter (1700/microL) and considers that anything below this is Neutropenia. However, others put this figure slightly lower at 1500 neutrophils per microliter (1500/microL). Your physician can best advise you as to what criteria he/she is using to diagnose you with Neutropenia.

Since neutrophils are manufactured in the bone marrow, anything that disrupts, damages or destroys your bone marrow or bone marrow function may cause Neutropenia, including:

• certain drugs (chemotherapy, antibiotics, diuretics)
• cancer
• autoimmune disorders (Lupus)
• congenital conditions (Myelokathexis, Kostmann syndrome)
• radiation therapy
• viral infections (Malaria, HIV/AIDS, tuberculosis, Epstein Barr virus – EBV, Mononucleosis)
• bone marrow diseases (leukemia, myelodysplastic syndrome, Aplastic anemia, Myelofibrosis)
• bone marrow transplants
• Hypersplenism
• Vitamin B12 deficiency

If you have Neutropenia, you’ll need to ensure that you take measures (such as hand washing, use of face masks, etc.) to avoid infections. Any existing infections or fungi must be treated with the appropriate antibiotic or anti-fungal medication. Your physician may recommend that you take a growth factor (recombinant granulocyte colony stimulating factor G-CSF) to stimulate production of neutrophils or that you take granulocyte transfusions. It’s also important to identify and treat the underlying cause of the Neutropenia as well.

Sources:
Neutropenia, The Mayo Clinic, 28 Aug 2008, http://mayoclinic.com/health/neutropenia/MY00110

Melissa Conrad Stoppler, MD and Mary Nettleman, MD, Neutropenia, http://www.medicinenet.com/neutropenia/article.htm

(Disclaimer: I am not a physician and nothing in this article should be construed as giving medical advice. As with any medical decision, please consult your physician.)

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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