• Neutropenia

    (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
    White Blood Cells
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    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
    • Chemotherapy
    • 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

    Risk Factors

    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
    • Weakness
    • 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.

    Removal of Causative Agent

    When possible, the toxin or drug that is causing the problems will be removed.


    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 http://www.mouthhealthy.org

    National Organization for Rare Disorders, Inc. http://www.rarediseases.org


    The College of Family Physicians of Canada http://www.cfpc.ca

    Health Canada http://www.hc-sc.gc.ca


    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.

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