Neutropenia D70.7

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Lack of peripherally circulating neutrophil granulocytes. In mild neutropenia, the absolute neutrophil count is between 1000 and 1500/μl, in moderately severe neutropenia between 500 and 1000/μl and in severe neutropenia below 500/μl blood. To calculate the absolute number of neutrophil granulocytes, the leucocyte count is multiplied by the result of the differential blood count (percentage of segment-nuclear and rod-nuclear neutrophil granulocytes and their immature precursors) in the peripheral blood.

Classification
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  • Mild neutropenia: 1000-1500 neutrophils/µl blood.
  • Medium neutropenia: 500-1000 neutrophils/µl of blood.
  • Severe neutropenia: < 500 neutrophils/µl of blood.
  • Differentiation between acute (< 3 months) and chronic neutropenia (> 3 months).

Etiopathogenesis
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Clinical features
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Neutropenia > 1000/µl are mostly asymptomatic; neutropenia < 1000/µl are clinically characterized by chronic and recurrent infections (mostly bacterial) such as aphthous stomatitis, abscesses, otitis media, tonsillitis, pneumonia. Fever attacks, sepsis. Signs of inflammation are attenuated.

Diagnosis
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  • Anamnesis and clinic, determination of the absolute neutrophil count, in case of chronic neutropenia 2 blood count controls/week over 6 weeks.
  • In case of clinical symptoms or severe infections, further diagnostics to exclude immune defects, malignant diseases, HIV infection, SLE.
  • Detection of autoantibodies against neutrophil granulocytes with simultaneous anaemia and/or thrombopenia or blasts in the peripheral blood smear. Bone marrow aspiration e.g. of a malignant infiltration of the KM.

Therapy
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Stopping suspicious medication, treatment of underlying diseases, antibiotic therapy (after taking blood cultures and smears). Subcutaneous application of granulocyte colony stimulating factor (G-CSF); in severe congenital forms: stem cell or KM transplantation.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020