Hematology and Oncology Book

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NeutropeniaAka: Granulocytopenia, Agranulocytosis, Schultz's Disease, Pseudoneutropenia

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  1. See Also
    1. Leukocytosis
    2. Neutrophil
  2. Definition: Neutropenia (Neutrophil Count < 1500/mm3)
    1. Agranulocytosis (severe neutropenia)
      1. Complete absence of Neutrophils
    2. Neutropenia: Based on Absolute Neutrophil Count (ANC)
      1. Mild Neutropenia: ANC 1000 to 1500 Neutrophils/mm3
      2. Moderate Neutropenia: ANC 500 to 1000 Neutrophils/mm3
      3. Severe Neutropenia: ANC <500 Neutrophils/mm3
  3. Causes
    1. See Neutropenia Causes
  4. Differential Diagnosis: Pseudoneutropenia (automated)
    1. Blood examined after long delay after phlebotomy
    2. Margination (see Neutropenia Causes)
    3. Neutrophil clumping
      1. Paraproteinemia
      2. Anticoagulant use
  5. Signs: Recurrent infection
    1. General
      1. Typical inflammation signs less commonly seen
      2. Swelling and heat less often seen with neutropenia
    2. Organisms
      1. Staphylococcus aureus (skin)
      2. Gram Negative (Gastrointestinal, Genitourinary)
    3. Early severe neutropenia
      1. Oropharyngeal infections
      2. Skin Infections or delayed wound healing
    4. Persistent severe neutropenia
      1. Pulmonary infection
      2. Gastrointestinal infection
      3. Sepsis
  6. Labs
    1. Complete Blood Count with Platelet Count
    2. Peripheral Blood Smear
  7. Evaluation: Bone Marrow Biopsy
    1. Indications
      1. Indicated in most neutropenia cases
      2. Not required in mild Drug-Induced Neutropenia
    2. Increased Granulocytes in Bone Marrow
      1. Suggests increased destruction (e.g. immune)
    3. Decreased Granulocytes in Bone Marrow
      1. Increased cells seen in marrow
        1. Suggests marrow infiltration (e.g. Leukemia)
      2. Decreased cells seen in marrow
        1. Suggests marrow injury (e.g. medications)
  8. Complications
    1. Severe neutropenia predisposes to serious infection

Agranulocytosis (C0001824)

Definition (MSH)A decrease in the number of GRANULOCYTES; (BASOPHILS; EOSINOPHILS; and NEUTROPHILS).
Definition (CSP)decrease in the number of granulocytes (basophils, eosinophils, and neutrophils).
Definition (NCI)A decrease in the number of mature granulocytes (neutrophils, eosinophils, and basophils) in the peripheral blood. -- 2004
ConceptsDisease or Syndrome (T047)
EnglishAgranulocytoses, Agranulocytosis, Granulocytopenia, Granulocytopenias, Granulocytopenic disorder, Granulopenia
Spanishagranulocitosis, granulocitopenia, granulopenia, trastorno granulocitopénico, trastorno granulocitopenico
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Neutropenia (C0027947)

Definition (MSH)A decrease in the number of neutrophilic leukocytes in the blood. (Dorland, 27th ed)
Definition (CSP)decrease in the number of neutrophilic leukocytes in the blood.
Definition (NCI)An abnormal decrease in the number of neutrophils, a type of white blood cell.
Definition (NCI)A deficiency in the number of granulocytes, a type of white blood cell.
ConceptsDisease or Syndrome (T047)
ICD9288.0, 288.00, 288.09
EnglishNeutropenia, NEUTROPENIA NEC, Neutropenias, Neutropenic disorder, Neutrophil count below reference range, NEUTROPHILS DECREASED, Other neutropenia
Spanishneutropenia, recuento de neutrófilo por debajo de los límites de referencia, recuento de neutrofilo por debajo de los limites de referencia, trastorno neutropénico, trastorno neutropenico
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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