Table of contents:
- What is neutropenia?
- What causes neutropenia?
- 1. Cancer and cancer treatments
- 2. Medicines
- 3. Infection
- 4. Autoimmune disease
- 5. Bone marrow disorders
- 6. Other causes
- What dangers can neutropenia pose?
- How to deal with low neutrophils?
Neutrophils are the most common type of white blood cell and have the highest levels. When this type of white blood cell count is lower than normal, you develop a condition known as neutropenia. This condition can make your body more susceptible to infection. So, what are the causes of low neutrophils and what are the dangers? Check out the explanation below.
What is neutropenia?
Neutropenia is a condition when the neutrophils in the blood are below normal levels, which are around 2,500-6,000 neutrophils / mcL.
Neutrophils themselves play an important role in dealing with infections in the body. Some people with below average neutrophil counts may not be at risk for infection. In this condition, a deficiency in the number of neutrophils is not a dangerous thing.
Even so, people with this condition are at very high risk of developing serious infections. This is because the body does not have a sufficient number of neutrophils to fight germs (pathogens) that cause infection.
Quoted from the Cleveland Clinic, there are three low levels of neutrophils, namely:
- Mild (there are 1,000-1,500 neutrophils / mcL of blood)
- Moderate (there are 500-1,000 neutrophils / mcL of blood)
- Severe (there are less than 500 neutrophils / mcL blood)
Mild neutropenia may not cause any symptoms. However, you can get an infection if this condition you are experiencing is severe.
Some of the possible symptoms of neutropenia if your condition is severe, the symptoms of neutropenia that you feel include:
- Fever
- Open sores (which may be difficult to heal)
- Boils (collection of pus)
- Swelling
- Recurrent infection
You may not even notice that you are experiencing a low neutrophil state because you don't have any symptoms. In fact, in some cases, a person does not know they have this condition until they have a blood test for other complaints that may not be related.
However, a blood test that shows low neutrophil levels does not necessarily mean that you have neutropenia. The levels of this type of white blood cell can vary from day to day, so you will need to have several blood tests to confirm the condition.
Low neutrophil levels can make you more susceptible to infection. When you have severely low neutrophils, normal bacteria from the mouth or digestive tract alone can cause serious illness.
What causes neutropenia?
Neutropenia occurs because neutrophils are used or destroyed faster than they are produced, or the bone marrow does not produce enough neutrophils. This condition can be acute (temporary), it can also be chronic (in the long term), especially if you don't get proper treatment.
Based on the cause, neutropenia can be divided into two types, namely due to birth and acquired (acquired) over time.
The following conditions can cause neutropenia:
1. Cancer and cancer treatments
Chemotherapy in cancer treatment is a common cause of neutropenia. This is because in addition to killing cancer cells, chemotherapy can also destroy neutrophils and other healthy cells.
One type of cancer that can reduce the number of neutrophils is leukemia. In addition, several treatments for cancer that also have the potential to cause neutropenia include:
- Chemotherapy
- Cancer radiation therapy
- Bone marrow transplant
- Steroid drugs
2. Medicines
Long-term use of drugs can also cause neutrophil levels to drop. The following are drugs that can cause neutropenia:
- Medicines to treat hyperthyroidism, such as methimazole (Tapazole) and propylthiouracil
- Several antibiotics, including vancomycin (Vancocin), penicillin G and oxacillin
- Antiviral drugs, such as ganciclovir (Cytovene) and valganciclovir (Valcyte)
- Anti-inflammatory drugs that treat colitis or rheumatoid arthritis, such as sulfasalazine (Azulfidine)
- Some antipsychotic drugs, such as clozapine (Clozaril, Fazaclo) and chlorpromazine
- Medicines used to treat irregular heart rhythms, such as quinidine and procainamide
- Levamisole, which is a veterinary drug that is not approved for use by humans, but can be mixed with cocaine
3. Infection
Various infectious diseases can also cause neutrophil levels to decrease, such as:
- Chicken pox
- Measles
- Other viral infections, such as Epstein-Barr (mononucleosis), viral hepatitis, HIV / AIDS
- Salmonella bacterial infection
- Tuberculosis
- Sepsis (an overwhelming bloodstream infection)
4. Autoimmune disease
In autoimmune neutropenia, the antibodies in the body continue to destroy neutrophils. As a result, the level of neutrophils in the body is very low.
Several autoimmune diseases that can cause neutropenia, namely:
- Granulomatosis with polyliitis (formerly called Wegener's granulomatosis)
- Lupus
- Rheumatoid arthritis
- Crohn's disease
5. Bone marrow disorders
Neutrophils along with other blood cells are made in the bone marrow. That is why, a disturbance in the bone marrow can be the cause of decreased neutrophil levels.
In some cases, bone marrow disorders can be congenital, that is, babies are born with problems with their bone marrow.
However, there are also several conditions or diseases that cause bone marrow disorders, such as:
- Aplastic anemia
- Myelodysplasia syndrome
- Myelofibrosis
6. Other causes
Several other conditions, including congenital conditions, can also cause low neutrophils. These conditions include:
- Conditions at birth, such as Kostmann's syndrome (a disorder that involves low neutrophil production)
- The reason for unknown, is called chronic idiopathic neutropenia
- Lack of vitamins or nutrients
- Spleen abnormalities
What dangers can neutropenia pose?
Fever is the body's natural response to an infection. However, fever during neutropenia can be a very serious condition.
Quoted from a journal published in the US National Library of Medicine, people with neutropenia accompanied by fever have an increased risk of death. This is a complication that includes an emergency.
In cancer patients, low neutrophil levels without fever can hinder chemotherapy treatment. Delays and changes in treatment patterns may have long-term effects on cancer cure.
Other serious complications of neutropenia include:
- Recurrent and fatal bacterial and fungal infections
- Bacteremia
- Septic shock
- Early death
- Failure to thrive
- Protein-energy malnutrition
- Multiorgan failure
Serious infections occur in some people with neutropenia, so they will need repeated treatment. Without treatment, very low levels of neutrophils can increase the risk of death.
How to deal with low neutrophils?
Some types of neutropenia may not require any treatment. However, if low neutrophil levels are accompanied by fever, you will need treatment.
The following are some of the treatment options that doctors recommend for treating neutropenia:
- Antibiotics. The doctor will recommend drugs to fight infection, such as antibiotics. If you have a fever, you will probably get an antibiotic infusion at the hospital.
- Discontinue treatment. If drugs are the cause of your neutropenia, your doctor may ask you to stop taking the drug.
- Treat the causative condition. If your neutrophil levels are low due to a vitamin deficiency, your doctor will try to treat your vitamin deficiency problem.
- Medicines that can increase the production of white blood cells. These medicines are usually given by injection called growth factors or colony stimulating factors.
- Granulocyte white blood cell transplant
- Anti-inflammatory drugs
- Bone marrow transplants can be useful in treating some severe types of neutropenia, including those caused by bone marrow problems
