(Agranulocytosis; Granulocytopenia; Granulopenia)
Neutropenia is the bone marrow’s inability to produce enough neutrophils, a type of white blood cell that helps to fight infections.
Neutropenia may be:
- Acquired—Develops after medical treatment or specific drugs; may appear suddenly or develop over time
- Congenital—Present at birth
White Blood Cells
Neutropenia can be caused by destruction or using up white blood cells and/or by the failure of bone marrow to make enough white blood cells.
With congenital neutropenia, these problems are caused by a genetic defect.
With acquired neutropenia, these problems may be caused by:
- Infections by virus, bacteria, or parasite
- Underlying inflammatory condition
- Drugs—used in medical treatment or recreational use
- Autoimmune disease—your immune systems attacks your own tissue such as white blood cells
- Damage to bone marrow usually by chemicals, radiation, or cancers
- Certain toxins
- Poor nutrition—particularly low protein intake
Factors that increase your chance of developing neutropenia include:
- Undergoing chemotherapy treatment for cancer
- Taking certain medications, including some antithyroid medication, antidepressants, antihistamines, and anticonvulsants
- Infection, especially viruses
- Exposure to certain chemical toxins or radiation
- Autoimmune diseases
- Enlargement of the spleen
- Vitamin B-12 or folate deficiency
- Leukemia or myelodysplastic syndromes
- Aplastic anemia or other diseases of the bone marrow
- Family history of certain genetic diseases
Neutropenia does not result in symptoms. However, it can result in infection, which may have the following symptoms:
- Rapid onset of fever and chills
- Sore throat
- Yellow skin color known as jaundice
- Mouth sores
- Bleeding gums
- Mild infections of skin, mouth, and nose
- Poor weight gain in children
You will be asked about your symptoms and medical history. You will be asked about recent infections, medical treatments, and medications. A physical exam will be done.
Your bodily fluids and tissues may be tested. This can be done with:
- Blood tests
- Bone marrow test
- Urine tests
Treatment will be based on the cause and severity of your neutropenia. Options include the following:
Medication for Infections Treatment
Antiviral, antibiotic, and antifungal medication may be needed to:
- Treat an infection that could be causing neutropenia
- Treat an infection that resulted from neutropenia
- Prevent an infection in people at high risk—this may include people with cancer or immune disorders
White Blood Cell-stimulating Factors
Granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) encourages the body to make more white blood cells.
You will be monitored if you are taking medication or having medical treatment that could lead to neutropenia. You may be given white blood cell stimulating medications before having treatments. This may prevent neutropenia.
Mouth Healthy—American Dental Association
National Organization for Rare Disorders, Inc.
The College of Family Physicians of Canada
Boulton F, Cooper C, et al. Neutropenia and agranulocytosis in England and Wales: incidence and risk factors. American Journal of Hepatology. 2003 Apr;72(4):248-54.
Neutropenia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116576/Neutropenia. Updated March 19, 2015. Accessed September 27, 2016.
Last reviewed June 2016 by Michael Fucci, DO, FACC
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.