Difference Between Neutropenia and Neutrophilia

Introduction:

Neutrophils are white blood cells that help the body fight against infections and provide immunity. They can increase or decrease in response to an infection, certain medicines used, some genetic conditions, or even stress. It is the most common among the white blood cells. Hence, they are also called the first line of defense for the body. The neutrophil count increases when the body has an injury or an infection. This helps the body recover quickly. On the other hand, when there is a chronic infection, cancer, or an autoimmune condition, the number of neutrophils decreases.

What Is the Normal Neutrophil Count in the Body?

In adults, the lowest limit for neutrophil count is about 1,500 neutrophils per microliter of blood by many standards. The normal white blood cell count can vary from person to person, depending on their age, sex, whether they have any other illness, pregnancy, etc.

The various ranges of neutrophil count are as follows:

1. Mild Neutropenia: 1,000 – 1,500 neutrophils per microliter of blood.

2. Moderate Neutropenia: 500 – 1,000 neutrophils per microliter of blood.

3. Severe Neutropenia: Less than 500 neutrophils per microliter of blood.

Do Neutrophils Increase in Number With Viral Infection?

The neutrophils act as the first line of defense, so in any viral infection, the number of neutrophils will increase.

What Is Meant by the Demargination of Neutrophil?

This is where neutrophils enter the peripheral circulation from regions of intravascularly marginated polymorphonuclear cells.

What Is Neutropenia?

When the neutrophil count in the body reduces to normal, it is called neutropenia. Neutrophil is a type of white blood cell produced by the bone marrow. When the neutrophil count decreases, the body finds it challenging to fight diseases and infections. In very severe cases, even the normal bacteria in the body can cause illness.

What Are the Causes of Neutropenia?

The most common causes of neutropenia can be;

1. Chemotherapy.

2. Radiation therapy.

3. Certain drugs.

Shwachman-Diamond Syndrome: It is an inherited condition that affects the bone marrow and the pancreas.

• Severe aplastic anemia.

• Some viral conditions.

• Conditions that affect the bone marrow.

• Vitamin and mineral deficiencies like vitamin B12, folic acid, and copper.

Who Is at Risk of Neutropenia?

The most commonly affected people are those who are constantly prone to infections. Cancer patients who are receiving chemotherapy are also prone to the condition. Studies show that about 50 percent of those who receive chemotherapy develop neutropenia. Benign Ethnic Neutropenia (BEN) is a chronic congenital condition common among African, Middle Eastern, and West Indian races. Although their neutrophil count is lower, people with the condition are not prone to infections.

In general, those who are at a high risk of neutropenia can include;

• Cancer patients.

• Leukemia.

• Those with a weak immune system.

What Is Neutrophilia?

When the body produces too many neutrophils, the condition is called neutrophilia. It can be a congenital condition (one is born with it) or due to some infections or conditions like stress or blood disorders. The causes of neutrophilia are classified as primary and secondary causes. The primary causes can include:

1. Chronic Myelogenic Leukemia:It is a type of cancer of the blood that affects the white blood cells.

2. Essential Thrombocytosis: This is a rare condition where the body produces a surplus of platelets.

3. Polycythemia Vera: It is a disorder of the blood where too many red blood cells are produced.

4. Juvenile Myelomonocytic Leukemia (JMML): It is a rare type of blood cancer usually seen in children. In this condition, the white blood cells do not mature efficiently.

5. Chronic Neutrophilic Leukemia: This is another rare blood disorder where the bone marrow produces too many neutrophils.

The secondary causes of neutrophilia can include;

1. Any infection or inflammation.

2. Chronic inflammatory conditions like rheumatoid arthritis and inflammatory bowel disease.

3. Vasculitis (inflammation of the blood vessels).

4. Some tumors.

5. Some medicines.

6. Stress.

7. Smoking.

8. Vigorous exercise.

What Is the Difference Between Neutrophilia and Neutropenia?

Neutrophilia is when the body produces too many neutrophils, more than usual. On the other hand, neutropenia is a condition when fewer than the required neutrophils are produced. Some infections or conditions, like chemotherapy, can cause neutropenia. Neutrophilia, as such, might not show any symptoms. But it can aggravate the symptoms of underlying conditions like a rise in temperature, tiredness, dizziness, recurring infections, wounds that delay healing, etc. The effect of neutropenia depends on its intensity. Mild conditions might not show any symptoms. Moderate to severe neutropenia can increase the risk of infection. Severe cases of neutropenia can be life-threatening if not treated properly.

How Are Neutrophilia and Neutropenia Diagnosed?

Since neutrophilia is usually a sign of an underlying condition, tests are done to determine the condition causing it. It can include physical examinations or tests to find blood disorders, signs of infection, or inflammation. A blood test also diagnoses neutropenia.

The commonly done tests to diagnose both conditions can include;

• Complete Blood Count (CBC): This helps to find the neutrophil count. Intermittent CBC can help trace the changes in neutrophil count over time.

• Antibody Blood Test: This helps to know if the condition is autoimmune (the body’s immune system attacking itself or the normal cells).

• Bone Marrow Aspirate: It helps to find out if any conditions associated with bone marrow or the production of neutrophils cause neutropenia or neutrophilia.

• Bone Marrow Biopsy: A piece of bony part in the bone marrow is collected in this test. It helps to find out if any malignancy causes the condition.

• Cytogenic and Molecular Testing: This helps to study the structure of the cells and to know if there is any abnormality in the structure of the neutrophils.

How Are Neutrophilia and Neutropenia Managed?

Since neutrophilia is a sign of the underlying condition, its cause must be diagnosed, and appropriate treatment should be given. Granulocyte-colony stimulating factors (G-CSF) are used for treating neutropenia. It is a synthetic version of the hormone that stimulates neutrophil production in the bone marrow. It is given as an injection daily under the skin (subcutaneous). When this does not work, a bone marrow transplant might be required. Antibiotics, anti-inflammatory drugs, corticosteroids, cytokines, etc., are also used for treating neutropenia. Treating the condition helps to improve the quality of life of the patient.

Conclusion:

A condition caused by an increased neutrophil count in the blood is called neutrophilia. On the other hand, a decrease in the neutrophil count is called neutropenia. Early diagnosis and management of these conditions are important to prevent complications. Generally, they are asymptomatic and are diagnosed while treating other conditions.