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NeutropeniaD70.7
DefinitionThis section has been translated automatically.
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.
ClassificationThis section has been translated automatically.
- 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).
EtiopathogenesisThis section has been translated automatically.
- Hematological causes and immunodeficiencies:
- Panmyelopathy (aplastic anaemia)
- Acute graft-versus-host disease
- Wiskott-Aldrich Syndrome
- Chédiak Higashi Syndrome
- dyskeratosis congenita
- Cartilage-hair hypoplasia
- Hyper-IgM Syndrome
- Xanthogranuloma, necrobiotic with paraproteinemia
- WHIM Syndrome
- Cyclic neutropenia.
- autoimmune diseases:
- Systemic lupus erythematosus
- Mixed connective tissue disease (Sharp syndrome)
- Felty syndrome.
- infections:
- HIV infection
- Cytomegaly
- Erythema infectiosum (Parvo B19 infection)
- EBV
- Acute viral hepatitis
- Malaria
- Measles.
- Metabolic causes:
- Other causes:
- Toxins
- Drugs, among other things. .:
- Caspofungin
- Ganciclovir
- Gold Preparations
- Griseofulvin
- Infliximab
- Interferons
- Lamivudine
- Metronidazole
- Retinoids
- Rifabutin
- Ticlopidine
- Zidovudine
- Numerous cytostatic drugs
- Irradiation.
Clinical featuresThis section has been translated automatically.
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.
DiagnosisThis section has been translated automatically.
- 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.
TherapyThis section has been translated automatically.
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.