Neutropenia: Difference between revisions

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== Introduction  ==
== Introduction  ==


Neutropenia is a low level of neutrophils in the blood<ref>Copeland et al. [https://bestpractice.bmj.com/topics/en-gb/893 Assessment of Neutropenia]. BMJ. 2021</ref>.  Neutrophils are a type of white blood cell, that support the immune system to fight injection by ingesting and killing invading microorganisms<ref>Justiz Vaillant AA, Zito PM. [https://pubmed.ncbi.nlm.nih.gov/29939524/ Neutropenia]. 2021 Nov 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29939524.</ref>. Neutropenia is defined as less than 1500 neutrophils per micro-litre of blood. It can be classed as mild (1000-1500 neutrophils per micro-litre), moderate ([[Tel:500-1000|500-1000]] neutrophils per micro-litre) or severe (less than 500 neutrophils per micro-litre)<ref name=":0">Schwartzberg LS. [https://pubmed.ncbi.nlm.nih.gov/17379162/ Neutropenia: etiology and pathogenesis]. Clin Cornerstone. 2006;8 Suppl 5:S5-11. doi: 10.1016/s1098-3597(06)80053-0. PMID: 17379162.</ref>. Neutropenia leads to an increased risk of infection and this risk is directly correlated with how long a patient has been neutropenic and how severe the neutropenia is.   <ref name=":0" />.  
Neutropenia is a low level of neutrophils in the blood<ref>Copeland et al. [https://bestpractice.bmj.com/topics/en-gb/893 Assessment of Neutropenia]. BMJ. 2021</ref>.  Neutrophils are a type of white blood cell, that support the immune system to fight injection by ingesting and killing invading microorganisms<ref>Justiz Vaillant AA, Zito PM. [https://pubmed.ncbi.nlm.nih.gov/29939524/ Neutropenia]. 2021 Nov 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29939524.</ref>. Neutropenia is defined as less than 1500 neutrophils per micro-litre of blood. It can be classed as mild (1000 to 1500 neutrophils per micro-litre), moderate (500 to 1000 neutrophils per micro-litre) or severe (less than 500 neutrophils per micro-litre)<ref name=":0">Schwartzberg LS. [https://pubmed.ncbi.nlm.nih.gov/17379162/ Neutropenia: etiology and pathogenesis]. Clin Cornerstone. 2006;8 Suppl 5:S5-11. doi: 10.1016/s1098-3597(06)80053-0. PMID: 17379162.</ref>. Neutropenia leads to an increased risk of infection and this risk is directly correlated with how long a patient has been neutropenic and how severe the neutropenia is.   <ref name=":0" />.  


== Aetiology ==
== Aetiology ==
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== Clinical Presentation  ==
== Clinical Presentation  ==


Neutropenia itself is asymptomatic until an infection develops<ref>M. Territo. [https://www.msdmanuals.com/professional/hematology-and-oncology/leukopenias/neutropenia Neutropenia]. MSD Manual Professional Edition. 2021</ref>.<br>  
Neutropenia itself is asymptomatic until an infection develops, whereby [[fever]] is the primary symptom<ref>M. Territo. [https://www.msdmanuals.com/professional/hematology-and-oncology/leukopenias/neutropenia Neutropenia]. MSD Manual Professional Edition. 2021</ref>. Usual signs of inflammation and infection can occur but may be reduced in neutropenic patients, due to the reduced immune response<ref name=":1">A. Urabe, [https://academic.oup.com/cid/article/39/Supplement_1/S53/401452 Clinical Features of the Neutropenic Host: Definitions and Initial Evaluation], Clinical Infectious Diseases, Volume 39, Issue Supplement_1, July 2004, Pages S53–S55, <nowiki>https://doi.org/10.1086/383055</nowiki> </ref>. 


== Diagnostic Procedures ==
== Diagnostic Procedures ==


add text here relating to diagnostic tests for the condition<br>  
* Subjective history
* Physical examination
* Full blood count including creatinine and CRP<ref name=":1" />.
* Chest radiography for patients with respiratory symptoms<ref name=":1" />.


== Outcome Measures ==
== Outcome Measures ==


add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]])  
add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]])  

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Introduction[edit | edit source]

Neutropenia is a low level of neutrophils in the blood[1]. Neutrophils are a type of white blood cell, that support the immune system to fight injection by ingesting and killing invading microorganisms[2]. Neutropenia is defined as less than 1500 neutrophils per micro-litre of blood. It can be classed as mild (1000 to 1500 neutrophils per micro-litre), moderate (500 to 1000 neutrophils per micro-litre) or severe (less than 500 neutrophils per micro-litre)[3]. Neutropenia leads to an increased risk of infection and this risk is directly correlated with how long a patient has been neutropenic and how severe the neutropenia is.   [3].

Aetiology[edit | edit source]

Neutropenia can develop due to a wide range of one or more causes[4].

Neutropenia can be caused by[5]:

  • Congenital neutropenia
  • Infection
  • Drug induced
  • Autoimmune response
  • Malignancy
  • Dietary deficiencies


Clinical Presentation[edit | edit source]

Neutropenia itself is asymptomatic until an infection develops, whereby fever is the primary symptom[6]. Usual signs of inflammation and infection can occur but may be reduced in neutropenic patients, due to the reduced immune response[7].

Diagnostic Procedures[edit | edit source]

  • Subjective history
  • Physical examination
  • Full blood count including creatinine and CRP[7].
  • Chest radiography for patients with respiratory symptoms[7].

Outcome Measures[edit | edit source]

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions
[edit | edit source]

add text here relating to management approaches to the condition

Differential Diagnosis
[edit | edit source]

add text here relating to the differential diagnosis of this condition

Resources
[edit | edit source]

add appropriate resources here

References[edit | edit source]

  1. ↑ Copeland et al. Assessment of Neutropenia. BMJ. 2021
  2. ↑ Justiz Vaillant AA, Zito PM. Neutropenia. 2021 Nov 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29939524.
  3. ↑ 3.0 3.1 Schwartzberg LS. Neutropenia: etiology and pathogenesis. Clin Cornerstone. 2006;8 Suppl 5:S5-11. doi: 10.1016/s1098-3597(06)80053-0. PMID: 17379162.
  4. ↑ Frater JL. How I investigate neutropenia. Int J Lab Hematol. 2020 Jun;42 Suppl 1:121-132. doi: 10.1111/ijlh.13210. PMID: 32543073
  5. ↑ Christopher Gibson, Nancy Berliner; How we evaluate and treat neutropenia in adults. Blood 2014; 124 (8): 1251–1258. doi: https://doi.org/10.1182/blood-2014-02-482612
  6. ↑ M. Territo. Neutropenia. MSD Manual Professional Edition. 2021
  7. ↑ 7.0 7.1 7.2 A. Urabe, Clinical Features of the Neutropenic Host: Definitions and Initial Evaluation, Clinical Infectious Diseases, Volume 39, Issue Supplement_1, July 2004, Pages S53–S55, https://doi.org/10.1086/383055
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