neutropenia

DEFINITION 

Neutropenia is a very small number of neutrophils in the blood.
Neutrophils are a major cellular defense system in the body to fight bacteria and fungi.Neutrophils also helps healing of wounds and eat the remains of a foreign body.

Neutrophil maturation in the bone marrow takes over 2 weeks.After entering the bloodstream, circulating neutrophils followed for approximately 6 hours, looking for the infecting organisms and other foreign objects.

If found, the neutrophils will move into the network, attach itself to the foreign object and produces materials that kill and digest toxins foreign objects.

This reaction can damage healthy tissue in the area of ​​infection.

This whole process is generating an inflammatory response in the infected area, which appears as redness, swelling and heat.

Neutrophils usually represents about 70% of all white blood cells, so the decrease in white blood cell count is usually also means a decrease in the total number of neutrophils.

If the neutrophil count reaches less than 1,000 cells / microliter, the likelihood of infection increased slightly; if it amounts to less than 500 cells / microliter, the risk of infection will be greatly increased.Without the key defense neutrophils, someone could die because of infection.

CAUSE

Neutropenia has many causes.Decrease in neutrophil counts can be caused due to the reduced formation of neutrophils in the bone marrow or because of destruction of large numbers of white blood cells in circulation.
Aplastic anemia causes neutropenia and lack of other blood cell types.

Other hereditary diseases that rarely occur, such as infantile genetic agranulocytosis and neutropenia familial, jumla also cause a reduction in white blood cells.

In cyclic neutropenia (a rare disease), neutrophil count fluctuated between normal and low every 21-28 days; number of neutrophils can be close to zero and then spontaneously returned to normal after 3-4 days.At the least amount neutrofilnya, enderita disease tends to have an infection.

Some people with cancer, tuberculosis, myelofibrosis, viatamin B12 deficiency and folic acid deficiency experienced neutropenia.Certain medications, particularly those used to treat cancer (chemotherapy), can disrupt the ability of bone marrow in neutrophil shape.Drugs that can cause neutropenia:

      1. Antibiotics (penicillin, sulfonamides, chloramphenicol)

2. Anti-seizure

3.  Anti-thyroid drugs

4.   Chemotherapy for cancer

5.  Gold salts

6. Phenothiazines.

In certain bacterial infections, some allergic diseases, several autoimmune diseases and some medications; destruction of neutrophils is faster than its formation.

In an enlarged spleen (eg, Felty syndrome, malaria, or sarcoidosis), could decrease the number of neutrophils because neutrophils trapped and destroyed in an enlarged spleen.

SYMPTOMS

Neutropenia can occur suddenly in a few hours or several days (acute neutropenia) or may last for several months or years (chronic neutropenia).Neutropenia has no specific symptoms, so it tends to go unnoticed until the occurrence of infection.

In acute neutropenia, and fever can occur open sores (ulcers, ulcers) that feels pain around the mouth and anus.That will be followed by bacterial pneumonia and other infections.

In chronic neutropenia, travel sickness is not too heavy if the number of neutrofilnya not too low.

DiagnosisIf a person experiences recurrent infections or unusual infections, then the suspicion of a neutropenia and complete blood counts performed for diagnosis.The number of neutrophils that little show neutropenia.

Subsequently sought the cause of neutropenia.Performed bone marrow aspiration or biopsy.Examples of the bone marrow is examined under a microscope to determine the state of the bone marrow, the number of precursors of neutrophils and white blood cell count.

By determining the amount of a precursor and maturation, one might expect the time required to return the number of neutrophils to normal numbers.If the number of precursor cells is reduced, a new neutrophil dkan not appear in the blood stream within 2 weeks or more, if the amount is sufficient and normal maturation, the newly akanmuncul neutrophils in the bloodstream within a few days.

Sometimes the bone marrow examination could find the existence of other diseases, such as leukemia or other blood cell cancers.

TREATMENT

Treatment of neutropenia depends on the cause and severity of the disease.Drugs that may cause neutropenia discontinued its use.

Sometimes the bone marrow recover by itself, does not require treatment.Patients with mild neutropenia (having more than 500 neutrophils / microliter of blood), usually have no symptoms and require no treatment.

In severe neutropenia (having less than 500 cells / microliter of blood) could be an infection because the body is unable to fight infection-causing organisms.

If an infection occurs, the patient should be hospitalized and immediately given strong antibiotics, even before the cause and the affected area of ​​infection was found.Fever (symptoms which usually indicate the presence of infection in patients with neutropenia) is an important sign that requires immediate medical attention.

Growth factors that stimulate white blood cell formation, especially granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF), can sometimes help.This treatment can reduce episodes neutropeni on cyclic neutropenia.

If the cause is an allergic reaction or an autoimmune reaction, given corticosteroids.

Globulin anti-timosit or type of immunosuppressive therapy (therapy that suppresses immune system activity) lainnyabisa used if suspected of an autoimmune disease (eg certain aplastic anemia).

If neutrophils trapped in the spleen is enlarged, then removal of the spleen can increase the number of neutrophils.

If immunosuppressive therapy fails, penderia aplastic anemia may need to undergo bone marrow transplantation.Bone marrow transplantation can cause significant toxic effects, require long-term hospital care and can only be done in certain circumstances.Usually for neutropenia was not performed bone marrow transplantation.

Source : http://medicastore.com/penyakit/119/Neutropenia.html