II. Definition: Neutropenia (Neutrophil Count < 1500/mm3)
- Agranulocytosis (severe Neutropenia)
- Complete absence of Neutrophils
- Neutropenia: Based on Absolute Neutrophil Count (ANC)
- Mild Neutropenia: ANC 1000 to 1500 Neutrophils/mm3
- Moderate Neutropenia: ANC 500 to 1000 Neutrophils/mm3
- Severe Neutropenia: ANC <500 Neutrophils/mm3
III. Precautions
- See Neutropenic Fever
- Avoid Rectal Exam in Neutropenia (theoretic risk of bacteremia)
IV. Causes
V. Differential Diagnosis: Pseudoneutropenia (automated)
- Blood examined after long delay after phlebotomy
- Margination (see Neutropenia Causes)
- Neutrophil clumping
VI. Signs: Recurrent infection
-
General
- Typical inflammation signs less commonly seen
- Swelling and heat less often seen with Neutropenia
- Organisms
- Staphylococcus Aureus (skin)
- Gram Negative (Gastrointestinal, Genitourinary)
- Early severe Neutropenia
- Oropharyngeal infections
- Skin Infections or delayed Wound Healing
- Persistent severe Neutropenia
- Pulmonary infection
- Gastrointestinal infection
- Sepsis
VII. Labs
VIII. Evaluation: Bone Marrow Biopsy
- Indications
- Indicated in most Neutropenia cases
- Not required in mild Drug-Induced Neutropenia
- Increased Granulocytes in Bone Marrow
- Suggests increased destruction (e.g. immune)
- Decreased Granulocytes in Bone Marrow
- Increased cells seen in marrow
- Suggests marrow infiltration (e.g. Leukemia)
- Decreased cells seen in marrow
- Suggests marrow injury (e.g. medications)
- Increased cells seen in marrow
IX. Complications
- Severe Neutropenia predisposes to serious infection
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Definition (NCI_NCI-GLOSS) | A condition in which there is a lower-than-normal number of granulocytes (a type of white blood cell). |
Definition (NCI) | A decrease in the number of mature granulocytes (neutrophils, eosinophils, and basophils) in the peripheral blood. |
Definition (CSP) | decrease in the number of granulocytes (basophils, eosinophils, and neutrophils). |
Definition (MSH) | A decrease in the number of GRANULOCYTES; (BASOPHILS; EOSINOPHILS; and NEUTROPHILS). |
Concepts | Disease or Syndrome (T047) |
MSH | D000380 |
ICD10 | D70 |
SnomedCT | 191350006, 154830007, 165508008, 142919000, 310589001, 191336001, 17182001, 72885007, 417672002 |
English | Agranulocytoses, Agranulocytosis, Granulocytopenia, Granulocytopenias, AGRANULOCYTOSIS, GRANULOCYTOPENIA, Agranulocytosis NOS, agranulocytosis (diagnosis), agranulocytosis, granulocytopenia (diagnosis), granulocytopenia, Agranulocytosis [Disease/Finding], granulopenia, agranulocytoses, Agranulocytosis NOS (disorder), Agranulocytosis (finding), Granulocytopenia (disorder), Granulopenia, Agranulocytosis (disorder), Schultz, Granulocytopenic disorder (disorder), Granulocytopenic disorder |
French | AGRANULOCYTOSE, GRANULOCYTOPENIE, Agranulocytose, Granulocytopénie |
Portuguese | AGRANULOCITOSE, GRANULOCITOPENIA, Agranulocitose, Granulocitopenia |
Spanish | AGRANULOCITOSIS, GRANULOCITOPENIA, agranulocitosis (hallazgo), granulocitopenia, agranulocitosis, SAI (trastorno), granulopenia, agranulocitosis, SAI, granulocitopenia (trastorno), agranulocitosis (trastorno), agranulocitosis, trastorno granulocitopénico (trastorno), trastorno granulocitopénico, Agranulocitosis, Granulocitopenia |
German | AGRANULOZYTOSE, GRANULOZYTOPENIE, Agranulozytose, Granulozytopenie |
Swedish | Agranulocytos |
Japanese | カリュウキュウゲンショウショウ, ムカリュウキュウショウ, Schultz症候群, 顆粒球減少症, シュルツ症候群, 無顆粒球症, 顆粒球減少 |
Czech | agranulocytóza, granulocytopenie, Agranulocytóza, Granulocytopenie |
Finnish | Agranulosytoosi |
Italian | Granulocitopenia, Agranulocitosi |
Russian | AGRANULOTSITOZ, GRANULOTSITOPENIIA, АГРАНУЛОЦИТОЗ, ГРАНУЛОЦИТОПЕНИЯ |
Korean | 무과립세포증 |
Croatian | AGRANULOCITOZA |
Polish | Agranulocytoza, Granulocytopenia |
Hungarian | granulocytopenia, agranulocytosis |
Norwegian | Agranulocytose, Granulocytopeni |
Dutch | agranulocytose, granulocytopenie, Agranulocytose, Cytose, agranulo-, Granulocytopenie |
Ontology: Neutropenia (C0027947)
Definition (MSH) | A decrease in the number of NEUTROPHILS found in the blood. |
Definition (CSP) | decrease in the number of neutrophilic leukocytes in the blood. |
Concepts | Disease or Syndrome (T047) |
MSH | D009503 |
ICD9 | 288.0, 288.00 |
ICD10 | D70 , D70.9 |
SnomedCT | 191336001, 72885007, 142928004, 303011007 |
English | Neutropenias, NEUTROPENIA, neutropenia (diagnosis), neutropenia, Neutropenia, Neutropenia NOS, Neutropenia, unspecified, Neutropenia [Disease/Finding], Neutropenia (disorder), Neutropenia (finding), Disorder characterized by neutropenia, Neutropenic disorder, Neutropenic disorder (disorder), Neutropenia, NOS, Neutropenia (disorder) [Ambiguous] |
French | NEUTROPENIE, Neutropénie, Neutropénies |
Portuguese | NEUTROPENIA, Neutropenia, Neutropenias |
Spanish | NEUTROPENIA, neutropenia (trastorno), neutropenia, neutropenia (concepto no activo), neutropenia - trastorno (trastorno), neutropenia - trastorno, trastorno neutropénico, Neutropenias, Neutropenia |
German | NEUTROPENIE, Neutropenie, Neutropenien |
Italian | Neutropenia, Neutropenie |
Japanese | 好中球減少症, コウチュウキュウゲンショウショウ |
Swedish | Neutropeni |
Czech | Snížený počet neutrofilů, Neutropenie |
Polish | Neutropenia |
Hungarian | Neutropeniák, neutropenia |
Dutch | neutropenie, neutropenieën, Neutropenie |
Russian | НЕЙТРОПЕНИЯ |