Medications that Cause Neutropenia

Here is a link to a site that lists medications that can cause neutropenia:

http://www.globalrph.com/neutropenia.htm



For information on Shwachman-Diamond Syndrome check out Shwachman-Diamond America

Merck Neutropenia Article

Merck Neutropenia Article

Great article on Neutropenia, causes and degrees. Talks about inflammation of response (when ANC is below 200, inflammation response can be gone). Very detailed!


For information on Shwachman-Diamond Syndrome check out Shwachman-Diamond America

Neutrophil Dysfunction Classification

Neutrophil Dysfunction

Numerous disorders may cause neutropenia, which is defined as an absolute reduction in the number of circulating neutrophils.
The link above takes you to a page with the classification and diganosis info.

Lymphocytes, Neutrophils and Bacterial Infections

Lymphocytes are extremely important in the body's defense against various
infections. The two major types of lymphocytes are T cells that are involved
in cell-mediated immunity and the B cells that are involved in antibody
production. Lymphocytes are usually elevated in viral infections. Low
lymphocyte numbers may be seen in different diseases such as hepatitis,
lymphoma, or AIDS. The normal range of the lymphocyte count is 900 -
4500/µL. Monocytes are commonly known as macrophages and function in the
phagocytosis of organisms and other invading organisms. They are elevated in
blood diseases, certain infections or autoimmune diseases. The normal range
for the monocyte count is 90-1000 /µL.

Bacterial infections will often cause an increase in the total WBC count. If
this count is elevated (called leukocytosis), it may indicate the presence
of infection. Neutrophils normally consists of band neutrophils and
segmented neutrophils. Band neutrophils are less mature cells where the
nucleus has not yet segmented. They normally make up 0-6% of the WBCs.
Segmented neutrophils are the most mature type of cells. In some infectious
conditions, immature band cells increase in the blood creating a situation
called a "left shift." Individuals with chronic allergic conditions (such as
atopic rhinitis or extrinsic asthma) usually have elevated circulating
eosinophil counts.

Neutrophil Counts and Susceptibility to Infections

From the Hematology of Infancy and Childhood (5th Edition):

"Individual patients may be characterized as having mild neutropenia with neutrophil counts of 1000 to 1500 cells/uL, moderate neutropenia with counts of 500 to 1000 cells/uL, and severe neutropenia with counts generally fewer than 500 cells/uL. This stratification is useful for predicting the risk of pyogenic infections, because only patients with severe neutropenia have increased susceptibility to life-threatening infection, particularly if the neutropenia persists for more than a few
days. Endogenous bacteria are the most frequent invaders, but colonization with a variety of organisms of nosocomial origin is also common.

Susceptibility to bacterial infection, even with severe neutropenia, is quite variable. For example, some patients with chronic neutropenia due to autoantibodies do not experience serious infections over a period of many years even with neutrophil counts as low as 200 cells/uL (or even lower), most likely because these individuals have normocellular bone marrow."

Neutrophil Counts for Age and Race

Here's what the Hematology of Infancy and Childhood (5th Edition) says about the neutrophils counts for age and race:

Quite interesting, and contrary to other texts-- it also contradicts what it says later in this same textbook. I think this is because several people wrote this book and it wasn't proofed against the other authors (make sense?) ANYHOW here's what it says:

"Neutropenia is defined as an absolute decrease in the number of circulating neutrophils in the blood. Normal neutrophil levels should be stratified for age, race and other factors. For whites, the lower limit for neutrophil counts (neutrophils and bands) is 1000 cells/ul in infants between 2 weeks and 1 year of age. After infancy, the corresponding value is 1500 cells/ul Blacks have somewhat lower neutrophil counts, and the lower limits of normal can tentatively be considered from 200 to 600 cells/uL less relative to whites. The basis
for this observation is probably due to a relative decrease of neutrophils in the bone marrow storage compartment. Note that falsely low white blood cell counts can result when counts are done long after blood is drawn or after excessive leukocyte clumping in the presence of certain paraproteins."

What Decreases the Neutrophil Count?

NEUTROPHILS ARE DECREASED BY:

Bone marrow depression due to radiation or cytotoxic drugs

Infections: Typhoid, tularemia, brucellosis, hepatitis, influenza, measles, mumps, rubella, infectious mononucleosis

Hypersplenism: hepatic disease and storage diseases

Collagen vascular diseases, such as systemic lupus erythematosus

Deficiency of folic acid or Vitamin B12

*Second Edition of Diagnostic Tests by Springhouse

What Increases the Neutrophil Count?

Neutrophils are increased by:

Infections: osteomyelitis. otitis media, salpingitis, septicemia, gonorrhea, endocarditis, smallpox, chickenpox, herpes,Rocky Mountain spotted fever

Ischemic necrosis due to myocardial infarction, burns, or cancer

Metabolic disorders: diabetic acidosis, eclampsia, uremia, thyrotoxicosis

Stress response due to acute hemorrhage, surgery, excessive exercise, emotional distress, third trimester of pregnancy, or childbirth

Inflammatory diseases: rheumatic fever, rheumatoid arthritis, acute gout, vasculitis, myositis

*This comes from the Second Addition of Diagnostic Tests