Symptoms of neutropenia

Neutropenia refers to a decrease in the number of neutrophils in the blood, especially in newborns. The incidence rate is relatively high and the harm is relatively large. The types may also vary. For example, if the neutrophil count is moderately reduced, this condition is relatively self-limiting. If the neutrophil count is significantly reduced, the harm will be relatively large and may easily cause serious suppurative infections.

Symptoms of neutropenia

A peripheral blood white blood cell count below 4.0×109/L (4000/mm3) is called leukopenia, which is most commonly caused by neutropenia. An absolute neutrophil count lower than (1.8-2.0)×109/L (1800-2000/mm3) is called granulocytopenia; lower than (0.5-1.0)×109/L (500-1000/mm3) is called agranulocytosis, which is often accompanied by severe, difficult-to-control infections. Onset can be acute or slow. The patient's risk of infection is directly related to the duration and rate of neutrophil count decrease.

1. Moderate granulocytopenia

The course of the disease is often short and self-limited. Those with a slow onset often have a chronic course with intermittent attacks. Due to the body's compensatory function, some patients may not develop infection. There are no obvious clinical symptoms or there are non-specific manifestations such as dizziness, fatigue, low fever, pharyngitis, poor appetite, and physical weakness.

2. Neutrophils decreased significantly

It is often as low as below 1.0×109/L, or even completely absent, which is completely different from the general leukocytopenia. The patient may suddenly experience chills, high fever, sweating, and general discomfort. Severe infection almost always occurs within 2 to 3 days. Its blood picture is characterized by neutrophil counts above 1.0×109/L and a compensatory increase in monocytes. However, when infection occurs, monocytes are slower than granulocytes in chemotaxis or phagocytic bactericidal effects, so it is difficult for them to play a due protective role against severe suppurative infections. It is often complicated by severe infections or sepsis in the lungs, urinary tract, skin, oral mucosa and skin, with Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa being the most common. The mucosa may have necrotic ulcers.

3. Due to lack of granulocytes that mediate inflammatory response

The signs and symptoms of infection are usually not obvious; for example, severe pneumonia may only show slight infiltration on the chest X-ray, and there is no purulent sputum; severe skin infection will not form furuncle; pyelonephritis will not show pyuria, etc. The infection tends to spread rapidly and progress to sepsis. The mortality rate is very high. The cause of acute onset cases can often be found, such as aminopyrine drugs or radiation damage. After stopping the medication and undergoing emergency treatment, the patient's body temperature returned to normal and the number of white blood cells in the peripheral blood rebounded, indicating that the condition has improved. If the infection is not controlled in time, it can cause death.