Neutropenia: Difference between revisions
From IDWiki
(Created page with "== Etiologies == === Congenital === * Constitutional neutropenia: mild (ANC>1000), chronic * Benign ethnic neutropenia: mild (ANC>1000), chronic, usually in patients with Mediterranean or African ancestry * Benign familial neutropenia: same as above, but hereditary and not associated with a specific ethnicity * Cyclic neutropenia: hereditary, with severe neutropenia on a 21-day cycle since childhood * Others: severe congenital neutropenia, Schwachman-Diamond sy...") |
No edit summary |
||
(2 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
== Background == |
|||
* Low concentration of circulating neutrophils |
|||
{| class="wikitable" |
|||
!ANC |
|||
!Classification |
|||
|- |
|||
|≥1500 |
|||
|Normal |
|||
|- |
|||
|1000-1499 |
|||
|Mild |
|||
|- |
|||
|500-999 |
|||
|Moderate |
|||
|- |
|||
|<500 |
|||
|Severe |
|||
|- |
|||
|0 |
|||
|Agranulocytosis |
|||
|} |
|||
== Etiologies == |
== Etiologies == |
||
Line 12: | Line 36: | ||
* Infectious |
* Infectious |
||
** Active infection, particularly viral, but including severe sepsis from any cause; more common in the elderly |
** Active infection, particularly viral, but including severe [[sepsis]] from any cause; more common in the elderly |
||
** Post-infectious neutropenia, most commonly in children after viral infections (particularly varicella, measles, rubella, influenza, hepatitis, EBV, or HIV) |
** Post-infectious neutropenia, most commonly in children after viral infections (particularly [[varicella]], [[measles]], [[rubella]], [[influenza]], [[Viral hepatitis|hepatitis]], [[EBV]], or [[HIV]]) |
||
*** EBV and HIV can sometimes cause prolonged neutropenia; the rest are self-limited |
*** [[EBV]] and [[HIV]] can sometimes cause prolonged neutropenia; the rest are self-limited |
||
** Bacterial infections, including [[Brucella]], [[Rickettsiae]], and [[mycobacteria]] |
** Bacterial infections, including [[Brucella]], [[Rickettsiae]], and [[mycobacteria]] |
||
* [[Drug-induced neutropenia]], including [[agranulocytosis]] or more mild neutropenia |
* [[Drug-induced neutropenia]], including [[agranulocytosis]] or more mild neutropenia |
||
Line 23: | Line 47: | ||
** [[Felty syndrome]] (triad of [[rheumatoid arthritis]], splenomegaly, and neutropenia) |
** [[Felty syndrome]] (triad of [[rheumatoid arthritis]], splenomegaly, and neutropenia) |
||
* Malignancy |
* Malignancy |
||
** Acute leukemia |
** [[Acute leukemia]] |
||
** [[Myelodysplastic syndrome]] |
** [[Myelodysplastic syndrome]] |
||
** [[LGL leukemia]]: associated with [[rheumatoid arthritis]] and can present as a [[Felty syndrome]] |
** [[LGL leukemia]]: associated with [[rheumatoid arthritis]] and can present as a [[Felty syndrome]] |
||
Line 34: | Line 58: | ||
** [[Copper deficiency]] |
** [[Copper deficiency]] |
||
** Global caloric malnutrition, including [[anorexia nervosa]] |
** Global caloric malnutrition, including [[anorexia nervosa]] |
||
* Chronic idiopathic neutropenia |
* [[Chronic idiopathic neutropenia]] |
||
== Further Reading == |
|||
* How we evaluate and treat neutropenia in adults. ''Blood'' 2014; 124 (8): 1251–1258. doi: https://doi.org/10.1182/blood-2014-02-482612 |
Latest revision as of 15:15, 27 February 2024
Background
- Low concentration of circulating neutrophils
ANC | Classification |
---|---|
≥1500 | Normal |
1000-1499 | Mild |
500-999 | Moderate |
<500 | Severe |
0 | Agranulocytosis |
Etiologies
Congenital
- Constitutional neutropenia: mild (ANC>1000), chronic
- Benign ethnic neutropenia: mild (ANC>1000), chronic, usually in patients with Mediterranean or African ancestry
- Benign familial neutropenia: same as above, but hereditary and not associated with a specific ethnicity
- Cyclic neutropenia: hereditary, with severe neutropenia on a 21-day cycle since childhood
- Others: severe congenital neutropenia, Schwachman-Diamond syndrome, Fanconi anemia, dyskeratosis congenita, Chediak-Higash syndrome, myelokathesis, Griscelli syndrome II, and cartilage-hair hypoplasia
Acquired
- Infectious
- Active infection, particularly viral, but including severe sepsis from any cause; more common in the elderly
- Post-infectious neutropenia, most commonly in children after viral infections (particularly varicella, measles, rubella, influenza, hepatitis, EBV, or HIV)
- Bacterial infections, including Brucella, Rickettsiae, and mycobacteria
- Drug-induced neutropenia, including agranulocytosis or more mild neutropenia
- Autoimmune
- Primary: typically in patients less than 1 year old, can be severe, but usually resolves within 2 years
- Needs prophylactic antibiotics and GCSF
- Secondary: usually mild, in the context of a systemic autoimmune disease (with lupus being common and tends to reflect disease activity)
- Felty syndrome (triad of rheumatoid arthritis, splenomegaly, and neutropenia)
- Primary: typically in patients less than 1 year old, can be severe, but usually resolves within 2 years
- Malignancy
- Acute leukemia
- Myelodysplastic syndrome
- LGL leukemia: associated with rheumatoid arthritis and can present as a Felty syndrome
- Myeloma
- Lymphoma
- Myelophthisic process
- Dietary
- Vitamin B12 deficiency
- Folate deficiency
- Copper deficiency
- Global caloric malnutrition, including anorexia nervosa
- Chronic idiopathic neutropenia
Further Reading
- How we evaluate and treat neutropenia in adults. Blood 2014; 124 (8): 1251–1258. doi: https://doi.org/10.1182/blood-2014-02-482612