Neutropenia is a syndrome which describes a dangerously or abnormally low count of neutrophils in the blood stream. A neutrophil is a type of white blood cell. White blood cells or leukocytes are important pieces of the immune system. Neutrophils, lymphocytes, monocytes, eosinophils and basophils are all leukocytes. Atypical white blood cell count per cubic mm of blood should be be neutrophils – 3650, monocytes – 430, lymphocytes – 2500, eosinophils – 150 and basophils – 30. Neutrophils kill and absorb invasive microorganisms. Neutropenia occurs when the neutrophils count measures less than 2000 cells per cubic mm.
Congenital Neutropenia begins at birth and is usually severe and chronic. Acquired Neutropenia can develop at anytime, either spontaneously or as a symptom of an underlying disease or condition.
Chronic congenital neutropenia is either defined as Kostmann syndrome or cyclic neutropenia. Metabolic diseases associated with chronic Neutropenia are Shwachman-Diamond syndrome and glycogen-storage disease type 1b. Chronic neutropenias that are not congenital are defined as either idiopathic neutropenia or autoimmune neutropenia.
Symptoms for neutropenia are sore throat, fever, painful anal ulcers, painful mouth ulcers, impaired and reduced immune response and an abnormal susceptibility to bacterial infections.
Neutropenia has symptoms, but they can imitate other diseases. Often neutropenia is incidentally diagnosed when examining a patient for a different condition or disease. A blood test is the first step in diagnosis. The neutrophils count will indicate whether neutropenia is the correct diagnosis.
A bone marrow biopsy will also be conclusive in diagnosing this disease. A bone marrow biopsy is a procedure in which bone marrow is removed from one of the larger bones in the body and examined under a microscope by a pathologist. A bone marrow biopsy will determine if cells are maturing properly into neutrophils and other blood cells. A pathologist will be able to determine if the body is using too many neutrophils for an underlying condition; the bone marrow is not functioning properly in neutrophils production; or whether other conditions are responsible for neutropenia such as leukemia or blood cancers.
This disease is caused when neutrophils production of the bone marrow cannot keep up with the demands of infection or other external agents on the neutrophils count. Neutrophils are used up faster than they can be replaced. This can occur with bacterial infections, drug treatments or bacterial infections. Cancer, viral infections, bacterial infections, B12 or folic acid deficiencies, myelofibrosis and tuberculosis can all tax the production of neutrophils by bone marrow and lead to neutropenia. Radiation therapy that destroys bone marrow can also lead to neutropenia. Chemotherapy drugs, exposure to the toxin benzene and certain insecticides can cause the development of this disease.
Neutropenia treatment is dependent on the cause and severity. If drugs are the culprit, they are discontinued if possible. If neutropenia is caused by hypersplenism, a splenectomy may resolve the condition. People with mild neutropenia usually require no treatment, such as caused by a severe cold because it usually remedies itself.
Patients with severe, chronic neutropenia are extremely prone to infection. If an infection attacks these patients, strong antibodies are administered and hospitalization is required even before the source of the infection is determined. Fever in patients with severe neutropenia should always be taken very seriously – an indication for immediate medical intervention.
If neutropenia is caused by an autoimmune reaction, then corticosteroids are administered. Antithymocyte globulin may be used when neutropenia is diagnosed with a disease such as aplastic anemia.
When the cause of neutropenia is an underlying condition or disease, treatment of the disease can possibly alleviate neutropenia. Bone marrow transplants are not used to treat neutropenia.
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Corticosteroids like Methylprednisolone are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are also often used for severe allergies or skin problems, asthma, or arthritis.
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