Neutropenia - Causes, Symptoms, Diagnosis, and Treatments

What Are Neutrophils?

White blood cells (WBCs) are blood cells present in the human body. These cells function as part of the immune system, defending the body against infection and safeguarding it from harmful bacteria, viruses, and other foreign invaders. It is the bone marrow that produces these white blood cells. They are divided into five types, and each plays a distinct role in the immune system.

1. Neutrophils.

2. Lymphocytes.

3. Monocytes.

4. Basophils.

5. Eosinophils.

White blood cells are primarily composed of neutrophils. They are recognized as the initial line of defense of the immune system. When the body is infected, or another source of inflammation is present, specific molecules alert mature neutrophils, leaving the bone marrow and moving through the circulation to the injured place. When a person is sick or injured, the number of neutrophils in their blood increases to aid in healing. If a person has a long-term infection, cancer, an autoimmune illness, or is on specific drugs, the number of neutrophils may fall.

What Is Neutropenia?

A low number of neutrophils characterizes neutropenia. As a result, neutropenia can increase the susceptibility to infection in the body. Even typical germs from the mouth and digestive tract can cause significant sickness when neutropenia is severe. When a foreign intruder, such as bacteria, enters the body, there are low neutrophils to destroy it. There are different degrees of neutropenia, but the lower the absolute neutrophil count, the greater the risk of infection.

Neutropenia is classified into four types:

1. Congenital Neutropenia- Congenital neutropenia manifests itself at birth and primarily affects newborns and children. It results in extremely low neutrophil counts and, in rare cases, total neutrophil deficiency.

2. Cyclic Neutropenia- Cyclic neutropenia is a condition that occurs at birth and causes neutrophil levels to fluctuate on a 21-day cycle. A transient episode of neutropenia may occur, followed by normal levels for the remaining cycle. The process is then restarted.

3. Autoimmune Neutropenia- In autoimmune neutropenia, the body produces antibodies that attack neutrophils. These antibodies destroy neutrophils, resulting in neutropenia. They are most frequent among newborns and toddlers.

4. Idiopathic Neutropenia- Idiopathic neutropenia can occur at any age and affect anyone. The reason is unknown.

What Are the Signs and Symptoms of Neutropenia?

Neutropenia does not always induce symptoms. However, some people may experience additional symptoms due to the infection or the underlying condition leading to neutropenia.

There are several indications and symptoms of neutropenia, which may include:

• Fever.

• Pneumonia.

• Infections of the sinuses.

• Otitis media (ear infection).

• Gum inflammation (gingivitis).

• Omphalitis (navel infection).

• Abscesses on the skin (collections of pus).

• Wounds that are difficult to heal and take a longer time.

• Fatigue (extreme tiredness).

• Lymph nodes that are swollen.

• Sweating or chills.

• A toothache or a sore throat.

• Coughing and lack of breath.

• Mouth ulcers or ulcers around the anus.

• Infection-related pain, edema, and rash.

• Diarrhea and loss of appetite.

• Pain during urination or burning sensation and other urinary symptoms.

Severe congenital neutropenia can cause life-threatening symptoms and bacterial infections. These infections can spread through the skin and digestive and respiratory systems.

When medications cause neutropenia, patients may experience a fever, rash, and enlarged lymph nodes. People with cyclic neutropenia may have intermittent symptoms as their white blood cell count rises and decreases over time.

What Are the Causes of Neutropenia?

• Blood cancer can induce neutropenia. It can also occur during or after cancer therapies such as chemotherapy, a stem cell transplant, or immune-suppressing drugs. Neutropenia occurs when the bone marrow does not produce enough neutrophils, neutrophils break down too quickly, or neutrophils are eliminated.

• Genetic disorders, such as those that cause neutropenia, can be passed on from parents to their children.

• Common causes of neutropenia include viral, bacterial, and parasitic illnesses such as HIV, hepatitis, TB, sepsis, and Lyme disease.

• Cancer and other blood or bone marrow illnesses, such as leukemia and lymphoma, can impair the ability to produce enough healthy white blood cells in the body resulting in neutropenia. As a side effect, cancer therapies such as chemotherapy and radiation therapy can injure or kill neutrophils or the bone marrow that produces neutrophils.

• Medications for diseases unrelated to cancer can also cause low neutrophil numbers.

• Nutritional deficiencies, such as a lack of vitamins or minerals in the diet, such as vitamin B12, folate, or copper, can induce neutropenia.

• A few autoimmune defects cause healthy neutrophils to be destroyed. Crohn's disease, lupus, and rheumatoid arthritis are manifestations of autoimmune diseases.

How Is Neutropenia Diagnosed?

When patients have recurrent or atypical illnesses or if they are using medicines known to induce neutropenia, doctors recommend a number of tests to rule out the possibility of neutropenia. These include:

• Complete Blood Count (CBC)- This test determines the neutrophil count. Periodic complete blood count testing can assist the physician in monitoring neutrophil count variations.

• Antibody Blood Test- This test looks for signs of autoimmune neutropenia.

• Bone Marrow Aspiration- They may extract a bone marrow sample and study the cells under a microscope. This test can provide information about whether neutrophils are forming improperly in the bone marrow or if they are being destroyed after being created.

• Bone Marrow Biopsy- It includes taking a tiny sample of bone marrow from within the bones for examination.

• Cytogenetic and Molecular Testing- This testing assists the healthcare practitioner in studying the cell structures.

What Are the Therapies for Neutropenia?

Health care practitioners assess the source and severity of the neutropenia while deciding on therapy. Mild instances may not require treatment at all. Treatment options may include:

• Antibiotics- If there is a presence of neutropenia with a fever, antibiotic therapy may start. In severe cases, the physician will most likely advise getting antibiotics intravenously (through a vein) to combat the illness.

• Corticosteroids- In case of an autoimmune problem, the doctor may prescribe corticosteroids. These medications can inhibit (reduce) the immunological response of the body, which triggers neutrophil depletion.

• Granulocyte Colony-Stimulating Factor (G-CSF)- This may be prescribed to stimulate the formation of white blood cells in the bone marrow.

• Chemotherapy- It is a medicinal treatment that employs strong chemicals to kill rapidly developing cells in the body.

How to Prevent and Manage Neutropenia?

There are several things to take to avoid illness. Here are some pointers:

• Good dental hygiene, including regular teeth brushing and flossing.

• Good hygiene, including frequent hand washing.

• Keeping up with immunizations.

• Keeping away from sick individuals.

• Avoid raw fruits, vegetables, cereals, nuts, and honey, as well as unpasteurized dairy products and undercooked meat.

• Avoid hot tubs, pools, and rivers, and also shower in lukewarm water every day.

• Exercise regularly.

• Avoid any unhealthy habits.

• Never stroll around barefoot.

• Hydrate dry skin.

• When working with chemicals, use gloves.

• Limit sun exposure.

• Avoid crowded places, gardening, and pet waste.

• Wear a hospital mask to protect from pathogens in the air.

Conclusion

Neutropenia is affected by decreased neutrophil (a kind of white blood cell) count in the blood. Neutrophils aid in infection control. When there is neutropenia, pathogens that can make the body sick should be avoided at all costs. Neutropenia can continue for months or even years. It is referred to as acute when it lasts less than three months. It is referred to as chronic when it lasts for an extended period. Infections might be hazardous if neutrophil levels are low. However, when these illnesses go untreated, they can be fatal. Severe congenital neutropenia creates a risk for various diseases. The goal of neutropenia treatment is to help patients live everyday life. In addition, managing it can prevent further complications.