What Is Neutropenia?
Neutropenia is a pathological condition characterized by abnormally low levels of neutrophils in the blood. Neutrophils are a vital component of blood in that they play a vital role in the immune system of the body. The neutrophils are responsible for eliminating any microorganisms like bacteria and fungi and protect the body from various infections. A person with Neutropenia will have a severely compromised immune system and will be prone to frequent infections.[1, 2, 3]
A person with a neutrophil count of 1500 neutrophils per microliter or less is considered a neutropenic in adults. In children these numbers change. If the levels fall below 500 then it is considered to be severe neutropenia. In such cases even the natural bacteria present in the stomach, skin, and mouth can also cause serious infections. Some potential causes of Neutropenia can be decreased production of neutrophils in the bone marrow, increased utilization of it, and accelerated destruction due to some medical conditions or a combination of all of the three.[1, 2, 3]
Neutropenia can sometimes be temporary and tend to improve with treatment or it can be long-term. Sometimes, an infant is born with this condition and it is termed as congenital Neutropenia. Sometimes people tend to get this disease later on in life. These instances are termed as acquired Neutropenia.[1, 2, 3]
What Causes Neutropenia?
The epicentre where neutrophils are produced is the bone marrow. If this process is disrupted in such a way that the production of neutrophils are affected then Neutropenia is the result. The primary cause for Neutropenia is chemotherapy which is done to treat cancers. Studies estimate that around 50% of people receiving chemotherapy develop some level of Neutropenia.
Some of the other possible causes for this condition include blood cancer, certain classes of medications like antihypertensives, antipsychotics, and antiepileptics. Certain genetic condition can also cause Neutropenia such as Barth syndrome which can affect multiple systems of the body. Myelodysplastic disorders which cause abnormal blood cells due to a dysfunctional bone marrow can also cause Neutropenia.
Another medical condition called myelofibrosis which is quite rare and affects the bone marrow is also one of the causes of Neutropenia. People who abuse alcohol are vulnerable to low levels of neutrophils causing Neutropenia. Vitamin B12 deficiency, low levels of folate, and copper deficiency all have the potential to cause Neutropenia.
People with sepsis which is a serious and life threatening blood infection tends to excessively utilize neutrophils resulting in Neutropenia. Other infections like hepatitis, HIV, malaria and tuberculosis all can cause Neutropenia. Certain autoimmune disorders like rheumatoid arthritis, Crohn disease, and lupus all have the potential to cause Neutropenia. It has been observed that Neutropenia is more common in premature babies compared to babies that are born at the stipulated time.
What Are The Different Types Of Neutropenia?
Neutropenia can be of different types to include
Cyclic Neutropenia: This type of Neutropenia is quite rare and is genetic in nature. It is believed to affect 1 in 1000,000 people.
Kostmann’s Syndrome: This is yet another type of genetic Neutropenia in which the production of neutrophils in the marrow is impaired resulting in low levels. People with this condition often are prone to frequent infections at an early age.
Chronic Idiopathic Neutropenia: This is perhaps the most common form of Neutropenia and is seen predominantly in females.
Autoimmune Neutropenia: This condition arises when the immune system of the body mistakenly attacks the neutrophils and destroys them causing the levels to abnormally fall.
Shwachman-Diamond Syndrome: This is again a genetic disorder that affects the production of neutrophils in the bone marrow resulting in Neutropenia.
Isoimmune Neonatal Neutropenia: This condition arises when the antibodies of the mother infiltrates the placenta and attacks the neutrophils of the developing fetus resulting in the baby being born with Neutropenia. The effects of this condition can be extreme in that either it will be completely asymptomatic or it can cause sepsis. This condition normally resolves within the first two months after the baby is born.
How Is Neutropenia Treated?
The treatment for Neutropenia is determined by the cause of it. There are treatments available which limit the impact that it has on a person. These treatment include:
Granulocyte-Colony Stimulating Factor: This treatment uses a drug that stimulates the bone marrow to produce more neutrophils and release then in the blood thereby neutralizing the effects of Neutropenia. The most preferred medication for this is filgrastim. This medication is quite effective in treating patients who develop Neutropenia after cancer treatments, especially chemotherapy.
Antibiotics: This is given prophylactically to prevent any onset of infection in a person with Neutropenia. This is usually given when the neutrophil count in the person drops to abnormally low levels.
Aside from medications, there are also certain lifestyle changes that a person with Neutropenia will have to make. The purpose of this is to minimize the risk of any infection. These changes include:
- Regularly washing the hands with soap and water, especially after using the restroom
- Avoiding visits to places where the chances of contracting an infection is high like hospital or a daycare center
- Avoid sharing personal items like toothbrush, razors, and combs with anyone
- Take daily baths
- Ensuring that eggs and any nonvegetarian items are thoroughly cooked
- Keeping the house and kitchen clean and free of any dust or mites that can be a source of infection
- Washing all vegetables thoroughly before cooking
- Avoid any direct contacts with pet waste and wear gloves when handling animals
- Clean any open wounds thoroughly with soap and water and apply antiseptic cream at the earliest
Following these lifestyle changes along with the treatments that have been outlined above almost always keep the symptoms of Neutropenia in check. This is especially in people who have a genetic condition causing Neutropenia.