Neutropenia is a condition in which the body does not have enough neutrophils — a type of white blood cell that helps the body to fight bacterial infections. Neutropenia is defined as having an absolute neutrophil count of less than 1500/μL. The absolute neutrophil count (ANC) is calculated by multiplying the total white blood cell count by the percentage of neutrophils and band cells (which also are a type of white blood cell, important in helping to fight acute infections).
Severity of the Condition Defined:
The most common causes of neutropenia are viral infections (such as chicken pox or the flu). If children are neutropenic at the time of an acute viral infection, a repeat CBC should be obtained three to four weeks later to evaluate for resolution of neutropenia.
In rare cases, serial CBC's over the course of six to eight weeks and/or antibody testing may be necessary to help evaluate for causes of neutropenia in children.
Neutropenia is diagnosed by obtaining a complete blood count (CBC) and calculating the ANC. Neutropenia is diagnosed if the ANC is less than 1500/μL. It is important to note, however, that only those patients who have severe, chronic neutropenia are likely to develop life-threatening infections.
In addition to a laboratory assessment, neutropenia patients may have a history of frequent/recurrent infections, lung infections, chronic ear infections, skin infections, serious infections (e.g., meningitis, or bone infections) or chronic mouth ulcers. Occasionally there may be a history of family members who may have died in infancy due to acute infections.
Important note: patients who are diagnosed with neutropenia should be closely monitored for fever at home. Patients who develop a temperature greater than 101° F or a rapidly rising temperature should contact their pediatrician immediately. Rectal temperatures should never be taken when patients are neutropenic.