Neutropenia is the clinical significance of this indicator. What is neutropenia, how is it determined and how is it treated? What is neutropenia? Why does the disease develop?

Neutropenia is characterized by a significant decrease in neutrophils, a type of white blood cell, which is an important first line of defense against infection. The main complication of neutropenia is an increased risk of infection.

Most often, cancer patients develop neutropenia due to chemotherapy; The drugs used destroy neutrophils along with the cancer cells they are intended to destroy.

In this article we will discuss the causes, symptoms and treatment of neutropenia.

Facts about neutropenia

1. Neutrophils are the most common type of white blood cell.
2. One of the most common causes of neutropenia is chemotherapy.
3. There are often no symptoms other than an increased risk of infection.
4. Febrile neutropenia is a medical emergency.
5. A person with neutropenia should take extra precautions to avoid infection.

What are neutrophils?

Neutrophils are the most common type of white blood cell. They participate in the inflammatory response to infection, engulf microorganisms and destroy them by releasing enzymes.

Neutrophils are produced in bone marrow, the spongy interior of the body's larger bones. These are short-lived cells that are widely distributed throughout the body; they can penetrate tissues that other cells cannot penetrate. Neutrophils are the main component of pus and are responsible for its whitish-yellow color.

What is neutropenia?

Neutropenia is a condition in which there are abnormally low levels of neutrophils in the blood. Neutrophils are an important type of white blood cell vital to fighting pathogens, especially bacterial infections.

In adults, a count of 1,500 neutrophils per microliter of blood or less is considered neutropenia, with a count of less than 500 per microliter of blood considered severe.

In severe cases, even bacteria that are normally found in the mouth, skin and intestines can cause serious infections.

Neutropenia can be caused by decreased neutrophil production, accelerated neutrophil utilization, accelerated neutrophil destruction, or a combination of all three.

Neutropenia can be temporary (acute) or long-lasting (chronic). The condition is also divided into congenital and acquired neutropenia.

Symptoms and diagnosis of neutropenia

Neutropenia itself is not accompanied by any symptoms. Often the disease is discovered when the results of a blood test are obtained. For this reason, chemotherapy patients who are most at risk for the disease are regularly scheduled for blood tests.

The most serious problem with neutropenia is contracting an infection, which can easily spread throughout the body due to the lack of normal amounts.

Signs of infection include:

1. High or low temperature
2. Chills and sweating
3. Flu-like symptoms
4. Malaise
5. Mucositis - painful inflammation and ulceration of the mucous membranes of the digestive tract
6. Abdominal pain
7. Diarrhea and vomiting
8. Changes in mental state
9. Sore throat, toothache
10. Pain in the anus
11. Burning sensation when urinating
12. Frequent urge to urinate
13. Cough
14. Difficulty breathing
15. Redness or swelling around wounds
16. Unusual vaginal discharge

If the infection gets worse, there is a risk of developing febrile neutropenia, also called neutropenic fever. This condition requires emergency medical attention and is most common in cancer patients undergoing chemotherapy. Mortality rates range from 2 to 21 percent.

It is important that the infection be treated promptly in a neutropenic patient.

Febrile neutropenia is defined as:

1. Fever above 38.3 degrees Celsius or more than 38 for 1 hour or more.
2. Absolute neutrophil count 1500 cells per microliter or less.

Causes of neutropenia

Neutrophils are produced in the bone marrow. Anything that disrupts this process can cause neutropenia.

Most often, neutropenia is caused by chemotherapy during cancer treatment. In fact, half of cancer patients undergoing chemotherapy will have some degree of neutropenia.

Other potential causes of neutropenia:

1. Leukemia is blood cancer.

2. Certain medications - including antibiotics and drugs to treat high blood pressure, mental disorders and epilepsy.

3. Barth syndrome is a genetic disease.

4. Myelodysplastic syndromes.

5. Myelofibrosis.

6. Alcoholism.

7. Vitamin deficiency - most commonly vitamin B12, folic acid and copper deficiency.

8. Sepsis.

9. Pearson syndrome is a mitochondrial disease.

10. Certain infections - including hepatitis A, B and C, HIV/AIDS, malaria, tuberculosis, dengue fever and Lyme disease.

11. Hypersplenism - enlarged spleen due to sequestration of blood cells.

Some autoimmune diseases can reduce the number of neutrophils. These conditions include:

1. Crohn's disease
2. Rheumatoid arthritis
3. Lupus

Preterm babies are more likely to be born with neutropenia than babies born near their due date. In general, the lighter a child is, the more likely he is to have neutropenia.

In a person with neutropenia, severe infections develop rapidly.

Treatment of neutropenia

Treatment for neutropenia will depend on the underlying cause of the disease. Medical treatments to help reduce the impact of neutropenia include:

Granulocyte-colony-stimulating factor (G-CSF) is a glycoprotein that stimulates the production of neutrophils and other granulocytes in the bone marrow and releases them into the bloodstream. The most commonly used version of G-CSF is the drug filgrastim.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a naturally occurring glycoprotein that performs a similar role to G-CSF. Both promote neutrophil recovery after chemotherapy.

Antibiotics – Antibiotics are sometimes prescribed to reduce the chance of infection. Most often during a period when the number of neutrophils is extremely low.

Lifestyle precautions are necessary for people with neutropenia; they must minimize the risk of infection in everyday life.

Lifestyle precautions for people with neutropenia include:

1. Wash your hands regularly, especially after using the toilet

2. Avoid crowds and people who are sick

3. Do not use other people's personal items, including toothbrushes, drinking cups, cutlery or food

4. Shower daily

5. Thoroughly cook meat and eggs

6. Do not buy products in damaged packaging

7. Wash the refrigerator thoroughly and do not overfill it - this can increase the temperature

8. Wash any raw fruits and vegetables thoroughly or avoid eating them completely

9. Avoid direct contact with pet waste and wash your hands after handling any animals.

10. Wear gloves when in contact with the ground

11. Use a soft toothbrush

12. Using an electric razor rather than a razor

13. Wash any wounds with warm water and soap, use an antiseptic

14. Always wear shoes when going out into the open air.

15. Clean surfaces

16. Get vaccinated against flu

Types of neutropenia

Cyclic neutropenia is a rare congenital syndrome that causes fluctuations in the number of neutrophils, affecting 1 in 1,000,000 people.

Kostman's syndrome- a genetic disease in which neutrophils are not produced in sufficient quantities.

Chronic idiopathic neutropenia- a relatively common type of neutropenia, predominantly affecting women.

Myelocathexis- a condition in which neutrophils are unable to move from the bone marrow into the bloodstream.

Autoimmune neutropenia- The human immune system attacks and destroys neutrophils.

Shwachman-Diamond syndrome is a rare genetic disorder with multiple effects, including dwarfism, pancreas problems and low neutrophil counts.

Isoimmune congenital neutropenia is a condition in which antibodies from the mother cross the placenta and attack neutrophils in the developing baby.

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Neutropenia (NP) is a pathological condition of the body in which the level of neutrophils (NF) in one microcell sharply becomes less than one and a half thousand neutrophils.

In most cases, neutropenia acts as a complication of initial diseases, but can progress independently.

A decrease in this indicator leads to a greater chance of infection by bacteria, suppresses the immune system and gives access to infectious diseases to the body. The greater the decline of neutrophils, the greater the risk of infectious and bacterial diseases.

To prescribe effective treatment, it is always necessary to establish the root cause that contributed to the development of such a condition. The disease is quite rare and occurs in one person per one hundred and fifty thousand of the population.

Depending on the severity of the disease, according to statistics, death occurs in ten to sixty percent of registered cases.

Basic concepts of NP

The main cells that saturate the body are leukocytes, one of whose functions is to identify foreign agents, suppress them and store in memory the encounter with each of the individual types of harmful proteins.

Neutrophils are found in granulocytes, which are part of white blood cells containing special granules. Compared to all other components of granulocytes, their majority are neutrophils.

That is why the term agranulocytosis (decrease in the number of granulocytes) is called the identical term neutropenia.

The formation of purulent foci occurs due to the deformation of microbes, their tissue formations and neutrophils, which rapidly move from the blood to the site of inflammation.

Types of neutropenia

The initial classification of neutropenia is based on the severity of the disease.

The following three stages are distinguished:

Light degree characterized by the presence of 1000 to 1400 neutrophils per microliter of blood;
Average degree determined by indicators from 500 to 1000 NF;
Severe degree– decline of NF boundaries below five hundred per microliter.

The degree is proportional to the development of burdens. The last degree of neutropenia is characterized by progression of complications.

The extreme stage is characterized by both strong inflammatory processes and its disappearance, which indicates that the granulocytes are completely depleted.

What causes NP?

The progression of this pathological condition can be either an independent process or a consequence of various diseases.

Provoking factors include:

Long-term exposure to radiation on the body;
Congenital diseases and genetic mutations. These include congenital pathologies of immunity, disorders of granulocytes of genetic origin, etc.;
Deformation of neutrophils due to exposure to antibodies;
The formation of neutropenia as one of the symptoms of the initial disease (tuberculosis, bone cancer, HIV, lupus erythematosus);
Taking certain medications (analgesics, diuretics (diuretics), anti-inflammatory drugs).

To fully understand the processes of disease occurrence, we will consider each of its types separately.

Autoimmune neutropenia

It progresses due to the formation of destructive antibodies to neutrophils by the immune system. Such antibodies can be either emerging counteracting agents to other diseases, or specifically to neutrophils, if signs of other autoimmune diseases are not detected.

In most cases, this type of neutropenia is diagnosed in children with congenital pathologies of the immune system.

Severe forms of immune diseases contribute to the sudden decline of neutrophils and the rapid acquisition of diseases of infectious origin.

In newborns, neutropenia can be detected as a consequence of the transfer of antibodies from the mother when taking certain medications.

And also with a hereditary predisposition called parodic neutropenia (manifests from the first months, after which it appears every trimester).

Drug-induced neutropenia

In most cases, this type of neutropenia is registered in the adult age category. It progresses as a result of allergic reactions and toxic effects of medications. Chemotherapy, in this case, does not affect neutrophil levels in any way.

The occurrence of this type of neutropenia can occur after consuming antibiotics containing the following:

Penicillin;
Cephalosporin;
Chloramphenicol;
Certain types of antipsychotics;
Anticonvulsants;
Sulfonamides.

After using the above drugs, neutropenia may be recorded and monitored for seven days, after which the levels gradually normalize.

Also, manifestations of neutropenia are possible when using drugs aimed against the occurrence of seizures.

In this case, in addition to all the signs of neutropenia, rashes, increased body temperature and possible hepatitis are added.

Frequent provocateurs of neutropenia are chemotherapy and ion irradiation, since during these processes, young synthesizing bone marrow cells are affected.

Indicators of neutropenia can be recorded for up to one month from the date of the procedure. During this month, you need to take special care of the high risk of infection.

Infectious neutropenia

This type of pathological decline of neutrophils often accompanies acute viral diseases. During periods of damage to the body by infectious or viral diseases, the immune system is especially weak and the progression of possible complications is most possible.

In childhood, neutropenia mainly occurs in the form of neutrophils adhering to the walls of blood vessels. This species is short-lived and disappears after seven days.

A severe form of the pathological disease infectious neutropenia is HIV, sepsis and other serious complications, in which not only the disruption of NF synthesis progresses, but also the deformation of neutrophils in the body.

Febrile neutropenia

The main reason that provokes the progression of this type of neutropenia is a severe infectious disease, which begins when the use of cytostatics is prescribed. With this process, harmful microorganisms multiply at a time when the immune system is weak.

The causative agents of this type of neutropenia can be caused by microbes that are not a threat to many people (streptococci, herpes, etc.), but when they develop, in conditions of a small number of neutrophils, they lead to serious infectious diseases and death.

Basically, it can be determined by a rise in temperature, general weakness, and obvious signs of intoxication.

In this case, inflammatory foci are difficult to diagnose, since the immune system hardly reacts. The diagnosis is made by exclusion.

Benign neutropenia

This condition is a chronic condition and is common in children. It lasts for more than two years without showing symptoms or requiring therapy. Diagnosis of this type of neutropenia consists of determining low neutrophils, but normal other blood parameters.

It does not affect the development and growth of the child in any way. Bone marrow failure is the main version of doctors regarding the progression of such neutropenia.

How to determine the manifestation of NP?

The manifestation of symptoms when the body is affected by neutropenia is more clearly manifested in more severe stages of the disease. The main symptoms manifested are very similar to a blood disease in which the functioning of the bone marrow is inhibited.

Signs by which neutropenia can be determined are:

Ulcers with tissue death inside, located on the skin, mouth, chest and soft tissues;
Swelling of the oral cavity, its redness;
Covering the oral cavity with a white or yellow coating;
Necrotic ulcers in the intestines;
Pneumonia;
Cough;
A sharp increase in temperature;
The appearance of boils;
Acute pain in the abdominal area, with a clearly defined pain point;
Nausea and vomiting, regardless of food intake;
Constipation;
Fever;
Headache;
Pain in the joints.

As drug-induced neutropenia progresses, the most severe symptoms and the highest mortality rate occur. In the acute period of the disease, death occurs in thirty percent of cases.

With the development of neutropenia at the initial stages, symptoms are not visible. If neutropenia is suspected, it is necessary to carefully examine the oral cavity, skin, anus, places of insertion of catheters and vascular punctures, and also palpate the abdomen.

To make an accurate diagnosis, you need to take laboratory blood tests.

Norms

In a normal state, the quantitative indicator of neutrophils is from forty-five to seventy-five percent (or about 1500 per microliter of blood) of all leukocytes. It is the quantitative indicator of NF in the blood that plays an important role, since the number of other components of leukocytes can fluctuate, but the levels of neutrophils remain normal.

Normal rates vary slightly depending on a person's race. So in dark-skinned people, neutropenia is diagnosed when neutrophils decrease to less than 1200 per 1 microliter of blood. This happens because people with this skin color have lower neutrophil levels than white-skinned people.

The greater the deficiency of these components in leukocytes, the more pronounced the clinical manifestations and the greater the risk of progression of life-threatening complications. Severe forms of this disease are rarely recorded.

Normal NF indicators for childhood are shown in the table below:

	Total leukocytes		Neutrophils			Lymphocytes			Monocytes		Eosinophils
Age	average	range	average	range	%	average	range	%	average	%	average	%
birth	18.1	9--30	11	6--26	61	5.5	2--11	31	1.1	6	0.4	2
12 hours	22.8	13--38	15.5	6--28	68	5.5	2--11	23	1.2	5	0.5	2
24 hours.	18.9	9.4--34	11.5	5--21	61	5.8	2--11.5	31	1.1	6	0.5	2
1 Week	12.2	5--21	5.5	1.5--10	45	5	2--17	41	1.1	9	0.5	4
2 week	11.4	5--19.5	4.5	1--9.5	40	5.5	2--17	48	1	9	0.4	3
1 month	10.8	6--17.5	3.8	1--9	35	6	2.5--16.5	56	0.7	7	0.3	3
6 months	11.9	6--17.5	3.8	1--8.5	32	7.3	4--13.5	61	0.6	5	0.3	3
1	11.4	6--17	3.5	1.5--8.5	31	7	4--10.5	61	0.6	5	0.3	3
2	10.6	5.5--15.5	3.5	1.5--8.5	33	6.3	3--9.5	59	0.5	5	0.3	3
4	9.1	5.0--14.5	3.8	1.5--8.5	42	4.5	2--8	50	0.5	5	0.3	3
6	8.5	5--13.5	4.3	1.5--8	51	3.5	1.5--7	42	0.4	5	0.2	3
8	8.3	4.5--13.5	4.4	1.5--8	53	3.3	1.5--6.8	39	0.4	4	0.2	2
10	8.1	4.5--13.5	4.4	1.8--8	54	3.1	1.5--6.5	38	0.4	4	0.2	2
16	7.8	4.5--13	4.4	1.8--8	57	2.8	1.2--5.2	35	0.4	5	0.2	3
21	7.4	4.5-- 11.0	4.4	1.8--7.7	59	2.5	1--4.8	34	0.3	4	0.2	3

How is it diagnosed?

To make an accurate diagnosis, if neutropenia is suspected, the doctor will refer the patient for laboratory blood tests. The most common methods of blood testing for neutropenia include:

Diagnosis methods depend on the general condition of the patient and the suspicions of the attending physician.

How is NP treated in adults?

There is no one specific treatment regimen for neutropenia, since the symptoms are different for everyone and are provoked by different diseases. The severity of therapy depends on the age category of the patient, the nature of the bacteria that provoked the inflammation and the general health of the patient.

If the disease is mild, no treatment is required, and exacerbations that sometimes occur are treated with the same methods as for other affected people.

When diagnosing a severe form of neutropenia, constant medical supervision is required, twenty-four hours a day, so hospitalization cannot be avoided.

If the body is affected by diseases of infectious origin, the following groups of drugs are prescribed:

Antifungal;
Antiviral;
Antibacterial.

The dosage at the treatment stage is significantly higher than during the prevention of the disease.

The prescription of a particular drug mainly depends on the individual reaction of the body to the tolerance of a particular medication.

The main methods of therapy are:

Broad spectrum antibiotics. They are used until the doctor determines what is perceived best by the body. Such drugs are administered into a vein.

We are talking about improving the condition and using an effectively selected drug if the patient’s health improves in the first three days from the start of treatment. If no progress is observed, the dose is increased or another treatment is used;

When neutropenia progresses from radiation or chemotherapy, antibiotics are prescribed until the levels of NF in the blood reach at least five hundred neutrophils per microliter of blood:

Preparations of the fungicide group (Amphotericin) are used if fungal infections are added to infectious diseases, but fungicides are not used for preventive actions against fungal agents;
Colony-stimulating drugs (Filgastrim). Used for severe forms of neutropenia, as well as for children with congenital abnormalities of the immune system;
Vitamins (folic acid). Prescribed as maintenance therapy;
Glucocorticosteroids. Prescribed when neutropenia is provoked by immune diseases;
Medicines that improve metabolic processes in the body (Methyluracil, Pentoxyl). Prescribed as maintenance therapy.

In the case of a large number of deformed neutrophils in the cavities of the spleen, it is likely to be removed, but in severe forms of neutropenia, surgery is contraindicated.

The definitive treatment consists of surgery, which consists of a bone marrow transplant.

The treatment method is the most dangerous, but the most effective.

What is characteristic of NP in childhood?

The manifestation of poor bone marrow function is a major factor in the progression of neutropenia. In newborn children, neutrophil levels in the blood are diagnosed as neutropenia when their level drops to less than one thousand neutrophils per microliter of blood.

As the child grows, the norm increases and is set at one and a half thousand.

In the first year of life, the progression of neutropenia is characterized by an acute course or occurs chronically (with an increase in symptoms over several months).

Only three types of neutropenia are recorded in children:

Benign neutropenia of chronic type;
Neutropenia provoked by the immune system;
Hereditary predisposition and genetic mutations.

With mild neutropenia, in childhood, a slight decline in the quantitative indicator of neutrophils is recorded, and obvious symptoms, in many cases, do not appear. In some cases, there are frequent recurrent infectious diseases of an acute form, which tend to last a long time and are complicated by the presence of bacteria in the body.

In this case, effective therapy is medicines against viruses and medicines aimed at combating bacteria.

In the moderate stage, frequently recurring purulent inflammations are noted, and even the registration of an infectious shock state.

In the extreme stage of NP in children, severe intoxication, fever, and purulent inflammation are always manifested, localized in the chest, abdomen and oral cavity. If effective treatment is not applied, death often occurs.

For correct diagnosis, the following points must be observed:

When registering purulent foci with tissue death, it is necessary to carry out a blood culture to determine the microorganisms that provoke this condition;
For symptoms of moderate severity, a myelogram study should be performed;
Determination of all signs of neutropenia and a careful first examination of the child;
Identification of hereditary predisposition factors;
If neutropenia is viral, blood serum should be examined;
Every week it is necessary to do a clinical blood test and monitor all types of blood cells.

When a child’s body is affected by hereditary neutropenia, the general criteria are:

Detection of genetic defects using biological examinations;
The manifestation of obvious deviations, both externally and in test results, in the first three months after the birth of the child;
Heavy heredity.

Serious forms of hereditary neutropenia include the following:

Myelocachexia. With this type of neutropenia, there is a slow release of neutrophils from the bone marrow. This species is characterized by the accelerated breakdown of granulocytes into cells in the bone marrow and a low motor response of microorganisms to a chemical stimulus.

In the first year of life, the newborn has a relative lack of neutrophils and a clear increase in eosinophils, as well as a high level of monocytes in the blood.

When the body is damaged by bacteria, a pronounced decline in leukocytes in the blood is recorded.

Kostman's syndrome. It is a severe form of hereditary NP, which is characterized by the transmission of a pathological gene. A separate morbidity rate is also observed. When a child is affected by this syndrome, frequent damage to the child’s body occurs due to infectious and bacteriological diseases, which tend to recur frequently.

With this pathological condition, a clear decline in the number of neutrophils in the blood is recorded, sometimes reaching levels below three hundred NF per microliter of blood. Children affected by this syndrome are at risk for progression to leukemia.

When this disease is diagnosed in childhood, certain therapy is prescribed, which must be taken throughout life.
Colony-stimulating drugs (Filgrastim) are used for therapeutic purposes.

If this group of medications does not have the desired effect, then bone marrow transplantation is recommended, which is performed through surgery.

Cyclic neutropenia. It is a rather rarely diagnosed form of neutropenia, which is inherited. A characteristic difference from other types of neutropenia is an intermittent course, with the presence of periodic complications. This name has a clear framework for the repetition of exacerbations (usually from three to eight days) with breaks between attacks of two to three weeks.

When an exacerbation occurs, deviations appear in laboratory tests due to a sudden decrease in the number of neutrophils, and the concomitant growth of monocytes and eosinophils, as well as the appearance of formed purulent foci in different places of the body.

During periods of remission, the child’s general health is restored, and all test abnormalities return to normal.
A distinctive method of treating this type of neutropenia is the use of colony-stimulating factors 48 hours before the onset of a possible exacerbation.

The duration of therapy depends on how quickly the granulocyte count in the blood is restored.

Prevention

To prevent the progression of neutropenia, it is necessary to follow simple rules that will protect not only from this disease, but also from many others.

These include:

Normalize your daily routine by allocating time for proper sleep (at least 8 hours);
Moderate exercise for 30 minutes every day;
It is recommended to engage in light sports (physical education, swimming, etc.), and also allocate at least one hour a day for walking;
Avoid strenuous physical activity;
Eat properly. The diet must be balanced so that the body receives all the necessary nutrients and microelements;
Maintain the body at normal temperature. The body should not get too cold or too hot;
Avoid stressful situations. Eliminate strong emotional stress (both positive and negative), constant stress;
Get rid of bad habits. Toxins supplied with alcoholic beverages and cigarettes have a detrimental effect on the body.

Video: Neutropenia. How to prevent its consequences?

Experts' forecast

With timely access to the hospital, proper examination and rapid selection of effective complex therapy, the outcome is favorable.

If neutropenia is a symptom of another disease, then the course of treatment is aimed at eliminating the root cause. In severe forms, hospitalization and constant monitoring by health workers are necessary.

As well as a number of laboratory examinations aimed at determining the damaging factor. Only during hospitalization will the doctor be able to select the most appropriate medications, since each body reacts to certain types of medications individually.

If ignored or ineffective treatment, serious blood diseases progress, which after severe stages will lead to death.

To prevent diseases and timely diagnose them in the early stages, you need to take an annual blood test, undergo examinations and go to the hospital at the first symptoms.

There is a disease in which there is a reduced content of neutrophils in the blood, that is, blood cells, the maturation of which occurs over two weeks in the bone marrow. It has several forms. For example, it may be called febrile neutropenia. There is also a cyclic form of this disease and an autoimmune one. Any of them means that some changes have occurred in the blood, which, however, are reversible if the problem is identified in time.

The fact is that after neutrophils enter the circulatory system, their target becomes foreign agents, which they destroy. It turns out that neutrophils are responsible for protecting the body from bacteria. If their number is reduced, then the human body becomes more susceptible to various infections.

There are several degrees of neutropenia.

Mild degree, when there are more than 1000 neutrophils per μl.
Average degree, when there are from 500 to 1000 neutrophils per μl.
Severe degree, when there are less than 500 neutrophils per μl.

It happens that in one person the diagnosis includes both neutropenia and lymphocytosis. They are different from each other. Lymphocytosis is when there are too many lymphocytes in the blood, but they also provide immune defense to the body.

Reasons for decreased neutrophils

A reduced number of neutrophils in the blood can be either an independent anomaly or a consequence of various blood diseases. The causes of neutropenia may be the following:

Sometimes it is difficult for doctors to determine the cause. However, the causes of neutropenia help determine the form of the disease. Let's look at the three forms that we mentioned at the very beginning of this article.

Febrile neutropenia. It develops as a result of cytostatic chemotherapy, which is carried out mainly for leukemia. Most often, this form is a manifestation of an infection in which the focus cannot be identified in time. Such an infection itself has a severe course and rapid spread throughout the body, which leads to death.
Cyclic neutropenia. Unfortunately, the cause of the development of this form of the disease is not known, but its onset usually occurs in childhood.
Autoimmune neutropenia. This form can develop as a result of taking certain drugs, for example, analgin and anti-tuberculosis drugs. This disease is observed in rheumatoid arthritis, dermatomyositis, autoimmune diseases, and so on.

Some of these causes are similar to lymphocytosis, which may also be present in the diagnosis next to our disease. In any case, only a doctor can distinguish these diseases from each other. The symptoms observed in the patient largely depend on the types listed. It is very important to pay close attention to them, since making an accurate diagnosis largely depends on them.

Main symptoms

The symptoms of neutropenia do not have a specific picture, so we have to talk more about the clinical manifestations of this diagnosis associated with the infection that developed against its background. Such manifestations, as well as the degree of severity, again completely depend on the form of the disease.

Febrile neutropenia. It manifests itself as a sudden rise in temperature above 38 degrees. This is accompanied by chills, general weakness, tachycardia, heavy sweating, and hypotension. With all this, the number of neutrophils does not exceed 500, so the body reacts very weakly to infection, which does not allow its focus to be detected. The diagnosis of febrile neutropenia is made to patients precisely when it is impossible to quickly establish the cause of the elevated temperature in this disease and it is not possible to find its source.

If the cause is established, the diagnosis changes to a more accurate one. This form can manifest itself in cancer patients, as they are at risk of developing infectious diseases.
Cyclic neutropenia. It usually lasts about five days every three weeks. May be accompanied by fever, arthritis, headache, pharyngitis. Damage to the mouth area and ulceration of the mucous membrane may also occur. The ulcers have an oval or round appearance without signs of healing. If treatment is left untreated for a long time, plaque and tartar begin to form, and teeth may begin to fall out.

Autoimmune form. Its course can be recurrent, progressive or slow. Dangerous complications are bacterial infections, as they can lead to death.

It is worth recalling that cancer patients are at particular risk. They develop purulent-inflammatory complications much more often, although the risk of infection largely depends on the form of oncology and other factors.

Diagnostics

Diagnostics includes two important points.
Physical exam. The doctor examines an adult or small patient and examines the lymph nodes. He also palpates the abdomen.

Tests and trials. This includes blood tests, urine tests, bone marrow biopsies, and HIV tests.

Treatment of the disease

Treatment of the disease depends entirely on the cause that led to its occurrence. This means that most often the infection must be treated. The doctor decides in what conditions to carry out treatment, inpatient or at home.

After discussion, the conclusion suggests itself: a symptom arises - run to the doctor. But in order to detect a symptom, you need to be more attentive to your health, which does not tolerate self-indulgence.

Neutropenia has become one of the symptomatic diseases of our time. This term characterizes a state of the body in which it remains abnormal. The main causes and consequences of this phenomenon became the subject of research in this material. Here we will look at what neutropenia is in children and adults, what types and forms it has, how to get rid of such a disease and other relevant medical issues.

Features of diagnosis and treatment of neutropenia.

What is neutropenia

In normal conditions, in healthy adults and children, neutrophils make up 50% to 70% of all circulating white blood cells, acting as the body’s main defender against all kinds of infections, thoroughly searching for and destroying dangerous bacteria in the blood. If, for certain reasons, such an important proportion is violated, the protective function in the body is significantly weakened or disappears altogether, immediately leading to the appearance of many diseases dangerous to health and life. Such people become highly susceptible to acquiring various bacterial infections. This applies to both adults and children, in whom they occur quite often, although in most cases they occur without dangerous complications. However, at this age, their identification and diagnosis are very important.

Causes of the disease

The realities of life are such that neutropenia can arise and form literally before our eyes - within several days and even hours, acquiring an acute form. The main reasons for this phenomenon have long been established and studied by official medicine:

Congenital pathology.
Genetic failure.
Use of powerful medications (antidepressants, cytostatics, antihistamines, antitumor and anticonvulsants).
Radiation.
Weakened immunity.
Various ailments (malaria, typhoid fever, tuberculosis, helminthiasis, polio, diabetes, viral hepatitis, etc.).
Bone marrow damage.
Oncological diseases.
Lack of vitamin 12 and folic acid.

In the chronic form of the disease, which lasts for a long time, sometimes for whole years, everything is explained by a decrease in the volume or abnormal disproportion of the production of such cells.

Experts distinguish between the primary form of neutropenia, in which myeloid cells begin to form in the bone marrow structure, and the secondary form, when external factors influence the volume of myeloid cells in the bone marrow. Relative and absolute neutropenia is also recorded, which can, with various modifications, take the following forms of the disease:

Soft (initial).
Moderate (average).
Severe (acute)

These forms depend on the absolute number of neutrophils in the patient’s body. Infectious transient neutropenia is often associated with recent infectious diseases. Very dangerous is febrile neutropenia, observed most often in cancer patients, or the so-called. "neutropenic fever" This condition in patients occurs suddenly and develops very quickly with the number of neutrophils, representing a real threat to life. There are also other types of pathology - benign neutropenia of childhood, in which the child’s number of neutrophils performing protective functions sharply decreases. This phenomenon is recorded, as a rule, in one-year-old children, during their first year of life, and lasts from two to three months to several years, passing by itself. This does not exclude, of course, constant medical monitoring of the child.

Symptoms

In medical practice, the symptoms of neutropenia can go unnoticed for a long time, clearly manifesting themselves only in the acute, already sufficiently developed stage of the disease. Typical symptoms may be:

The appearance of pus.
Fever.
Frequently recurring infections leading to the formation of ulcers in the mouth, as well as diarrhea, an uncomfortable burning sensation during urination, and strange redness of the skin.
Pain and swelling around the wound.
Unpleasant feeling in the throat, etc.

Since the range of such symptoms is enormous, every unusual case of deviation from the norm should immediately attract close attention from an adult.

Particular attention should be paid to children in this regard. As soon as a child, especially an infant, exhibits strange symptoms like those just listed in the previous section, parents should take note and consult a pediatrician. We must also constantly remember the specifics of the infant form of the disease, which has its own differences compared to adults. Thus, children are diagnosed with benign chronic neutropenia, which is cyclical. In this form, the number of neutrophils changes, showing low levels and reaching the norm, and vice versa. The benign type of the disease goes away by 2-3 years. Doctors consider aplastic anemia to be the most common cause of the disease in children.

Vaccinations for illness

Vaccinations are proven methods of combating diseases of this kind. Unfortunately, adults often ignore them, considering them something unworthy of use, but this is a deep misconception, often leading to undesirable consequences. There is no need to talk about children. The entire range of medical vaccinations required for them must be completed in full, in strict accordance with the schedule for their implementation for different age categories.

It is worth recalling that cancer patients are at particular risk. They develop purulent-inflammatory complications much more often, although the risk of infection largely depends on the form of oncology and other factors.

Since the development of the disease in practice often leads to various kinds of complications, doctors strongly do not recommend allowing its spontaneous existence without treatment. As soon as any symptoms of the disease or strange deviations of the body from the norm are detected, it is necessary to undergo a thorough diagnostic study using highly effective equipment in order to accurately identify the causes and stage of the disease and begin its treatment. These diagnostic methods include:

Determination of the level of immunoglobulins in the blood.
Sometimes a bone marrow puncture is necessary. To do this, a small sample is taken from the ilium of the pelvis.
Genetic research (in the presence of congenital abnormalities).
Conducting a general blood test with a leukocyte formula (CBC with a formula).
Additional tests - test for lupus, determination of vitamin B12 levels.
X-ray of ENT organs, chest.

In some cases, it is possible that you will have to resort to genetic studies, bone marrow puncture and other serious laboratory tests.

Treatment

When the causes of the disease are established, treatment begins on the recommendation of the attending physician. There are many proven methods for treating neutropenia using a variety of medications. Before starting treatment, the doctor determines the form and severity of the disease, since the methods of control will depend on this. If the cause of the disease is an infection, it is necessary to get rid of it. This can be done in a hospital clinic or at home, the attending physician decides. The main emphasis is on strengthening the immune system. Medicines used for recovery include:

Vitamins.
Antibiotics.
Immunostimulants.

If there are ulcers in the mouth, use hydrogen peroxide, saline or chlorhexidine solution. They are used for rinsing. And painkillers are suitable for pain relief.

If the disease is severe, the patient is placed in an isolated room where sterility is strictly maintained and ultraviolet irradiation is carried out.

Treatment of neutropenia in children, in addition, will require a lot of patience from parents, as is often the case when older people communicate with young patients. You must be careful with the use of various antibacterial drugs, basing treatment solely on the advice of a professional doctor. Features of treatment of the disease in children:

If the disease appears due to the use of various medications, its use is stopped, and neutropenia itself does not require correction.
In severe cases, the child must be urgently hospitalized, since during such a course of the disease various infections quickly spread. In the hospital, the baby will be prescribed strong antibiotics, and growth factor drugs will be prescribed to stop the level of neutrophil leukocytes.
If this disorder was caused by an allergic or autoimmune condition, the use of corticosteroids is appropriate.
All cases of the disease involve the use of special drugs that increase immunity.
Sometimes a bone marrow transplant is required. This operation is performed on children over 12 years of age.

There are also traditional medicine recipes that help cope with this problem:

2 tbsp. l. walnut leaves pour 2.5 tbsp. boiling water, leave overnight, while the container should be well closed. You need to drink the drink ¼ tbsp. daily. The course of therapy is one month.
250 gr. finely chop the onion, add 1 tbsp. sugar and 500 ml. water. Afterwards the mixture is placed on low heat for 1-1.5 hours. The broth is cooled, 2 tbsp is added to it. l. honey, filtered and poured into a glass container. Drink 3 times a day, 1 tbsp. l.
0.5 kg. cranberries are softened and mixed with 2-3 pcs. apples, which are pre-cut into cubes, as well as 200 gr. walnut. Next, the drug is poured with 200 ml of water and 500 grams are poured. Sahara. All this is placed on the stove to bring to a boil, and then poured into a container. The medicine has the consistency of jam; it is eaten along with tea, 1 tbsp. per day.
2 cups of honey and 1 cup of dill are poured into 2 liters. hot water, you should also add 1 tbsp. l. valerian root and leave in a thermos for a day. Before taking the medicine, you need to strain it. It is recommended to drink the infusion 3 times a day, 1 tbsp. l. Be sure to store it in the refrigerator.
You can also make a balm. To do this, take 500 g. chopped walnut kernels, 300 gr. honey, 100 gr. aloe juice, 200 ml. vodka and 4 pcs. lemon. The resulting mixture is shaken well and placed in a dark place for a day. You need to drink this balm 3 times a day, 1 tbsp. l.

In addition to drug treatment and traditional medicine, following a special diet will not hurt. Such nutrition implies the exclusion of perishable foods from the diet, as well as poorly processed ones, since they may contain harmful bacteria and microbes. For a quick recovery, you should add the following products to your menu:

Pasteurized milk, yogurt, ice cream, parmesan, mozzarella, cheddar and Swiss cheese.
Pork, lamb, boiled or fried fish, beef, poultry.
Hard-boiled eggs.
Freshly prepared first courses.
Oranges, bananas, melons, tangerines, grapefruits.
It is allowed to consume canned, frozen fruits and pasteurized juices.
Rice, pasta, potatoes, noodles, and they can be prepared in any form.
Cookies, baked goods, bread.
Roasted nuts.

Do not forget about the need to drink 2 liters of liquid throughout the day: fruit drinks, water, juice, tea.

Prevention

The reliability of treatment is also ensured by the preventive side of the matter. When it comes to children, it is necessary to constantly monitor the child’s reliable oral hygiene, prevent stomatitis and other disease-promoting conditions of the child’s body. Constant preventive measures are, of course, fully necessary for an adult patient.