Neutropenia – Causes, Symptoms, Diagnostics, Treatment

Neutropenia is a condition in which the number of neutrophils in the blood is reduced. Because of this, bacterial and fungal diseases are much more complicated. The symptoms of the pathological process may be unexpressed, but the patient is rapidly developing a fever. In this case, broad-spectrum antibiotics are needed. When diagnosing neutropenia, it is important not only to determine the number of neutrophils, but also the reason for the decrease in their concentration. This condition often develops in cancer patients after chemotherapy.

Patients suffering from neutropenia need to remember the following facts:

• neutropenia is life-threatening. Statistics state that every 14 patients die from complications caused by this condition;
• 7-12 days after chemotherapy is the period of greatest risk. That’s when the neutrophil level is as low as possible;
• chemotherapy always causes neutropenia. Such an effect on the body kills not only cancer cells, but also healthy ones. Because of this, immunity is weakened;
• any infections with neutropenia progress very quickly. In patients after chemotherapy, body temperature can rapidly increase. If its value has risen above 38 degrees, you need to inform your doctor about it.

Possible causes of neutropenia

A huge number of factors can provoke the development of neutropenia. They can be natural and pathological. Most often, pathology is caused by:

• oncological diseases. Radiation and chemical therapy in the treatment of cancer damage the bone marrow. Also, the procedures kill not only cancer, but also useful blood cells. Because of this, the bone marrow cannot produce enough neutrophils for some time.;
• long-term use of medications. Agents for the treatment of thyroid hyperfunction, some antibiotics, antiviral, anti-inflammatory, antipsychotic drugs, complexes for the treatment of arrhythmias can contribute to neutropenia;
• infectious processes. Neutropenia is caused by HIV, AIDS, chickenpox, salmonellosis, measles, Epstein-Barr virus, hepatitis;
• autoimmune diseases. These are rheumatoid arthritis, systemic lupus erythematosus, granulomatosis, polyangiitis;
• bone marrow pathology. Such as aplastic anemia, myelofibrosis, myelodysplastic syndrome;
• beriberi. Deficiency of vitamins B, D can contribute to the development of neutropenia.

Neutropenia is a dangerous condition. It poses a serious threat to the health and life of the patient. Any infection occurring against its background significantly weakens the body.

The main symptoms of neutropenia

The rate of neutropenia occurrence depends on the severity of the infectious process, as well as the degree of decrease in the level of these blood cells. Usually, patients first of all form stomatitis, tonsillitis, pharyngitis appear. Due to the lack of movement of leukocytes, inflammation has a fibrotic-necrotic character.

A gray plaque forms on the mucous membranes, which indicates the development of a bacterial process. Infectious agents enter the general bloodstream and rapidly spread throughout the body. The patient has a headache, apathy, nausea, body temperature can reach 40 degrees. Also , the characteristic symptoms of neutropenia include:

• Rapid formation of ulcers. Initially, they spread along the mucous membranes of the cheeks. In the future, this may lead to gangrene of facial tissues. Then the gastrointestinal tract is affected: necrosis of the gastric mucosa, intestines, esophagus occurs;
• Due to the defeat of the gastrointestinal tract, severe pain and bloating appear. Deep disorders are manifested by hemorrhages. The risk of developing jaundice increases;
• Pneumonia. With neutropenia, it proceeds atypically, in the absence of treatment, it passes to neighboring organs. Tears and gangrene form on the lungs. You can determine inflammation by a strong cough, shortness of breath, chest pain when breathing;
• Disorder of the genitourinary system. The infection affects the bladder, urethra or uterus. In this case, the patient has pain in the lower abdomen, acute pains when urinating. Women are characterized by the appearance of whitish secretions from the vagina;
• Disorders in the cardiac work. Due to the general intoxication of the body, venous and arterial hypotension develops. When listening to the heart – there are functional noises;
• Kidney damage. The body removes protein against the background of the infectious agents’ activity. Blood and epithelial cells of the renal tubules are also found in the urine;
• Development of septic complications. Pathogenic agents rapidly spread throughout the body and cause numerous disorders. Due to saprophytic flora, blood poisoning can occur. In this case, the disease is very difficult, the body temperature increases to 41-42 degrees. Foci of black rash appear all over the body.

Neutropenia is a serious disease that, if a person doesn’t follow safety measures, it leads to serious complications and even death. If all the recommendations of the doctor are followed, the patient will be able to protect himself from such consequences. A mild degree of neutropenia is determined only by the results of a general blood test. Supportive medications are prescribed to prevent the increase of more serious symptoms.

Every patient with this pathology should be as attentive to their health as possible. Especially if he is in a high-risk group. It is necessary to consult a doctor if such symptoms appear:

• body temperature rose to 38;
• chills or profuse sweating;
• redness, pain, swelling with slight skin damage;
• shortness of breath, cough;
• itching, secretions from the genitals;
• painful and frequent urination;
• increasing abdominal pain;
• sore throat, oral cavity.

Diagnostic methods

Neutropenia often develops in patients who are susceptible to infections. People who have undergone radiation or chemical therapy are at increased risk. Neutropenia can be detected by a general blood test. According to the results, the doctor will be able to determine the infectious process in the body. Additionally, diagnostics includes the following studies:

• bacterial blood culture – identifies pathological agents;
• general urinalysis – determines kidney function;
• myelograms – bone marrow composition studies;
• lung radiography – diagnoses lung inflammation.

Treatment

There is no specific treatment regimen for neutropenia: the disease has a diverse course, causes of occurrence. The intensity of therapy will depend on the patient himself: his condition, age, degree of lesion and spread of the inflammatory process. Mild forms of neutropenia do not require any treatment. Exacerbations of infections are treated in the same way as in all patients.

Patients with severe neutropenia need to be under constant medical supervision – they are placed in a hospital. Antiviral, antibacterial, antifungal drugs with increased doses are prescribed. When choosing a medicine, it is necessary to analyze the sensitivity of microflora to active substances. Before receiving the results, the patient is intravenously injected with broad-spectrum antibiotics. If his condition has not improved after 3 days of drug therapy, increase the dose of the antibiotic or change the drug.

Patients with neutropenia who have developed the disease on the background of chemotherapy or radiation exposure are indicated to take antibiotics until the number of neutrophils reaches 500 mg / ml of blood. If a fungal one joins the infectious process, it is necessary to take fungicides. To minimize the risk of bacterial infection, the patient is prescribed trimethoprim sulfamethoxazole. Colony-stimulating factors are increasingly being used to treat neutropenia. To maintain immunity, it is necessary to take glucocorticosteroids, vitamin complexes.

If the spleen has been destroyed against the background of neutropenia, its surgical removal is indicated. However, the operation is categorically contraindicated in septic complications and severe forms of pathology. In the most advanced cases, a bone marrow transplant may be required.