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Low neutrophils count in the blood

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Low neutrophils count in the blood
Last update: 11/02/2021

What is a low count of neutrophils in the blood called?

  • Neutropenia

What is the normal count of neutrophils in the blood?

If you need to know which are the neutrophils reference ranges or you require more information about the role of neutrophils in the blood you can visit: Normal neutrophils count in the blood

What does a low count of neutrophils in the blood mean?

A low count of neutrophils is called neutropenia. Neutrophils are the most common type of WBC (White Blood Cell). They are the main cells involved in initiation of the inflammatory response and the first line of defense in response to invading pathogens (viruses, bacteria, or fungi).

The decrease of total neutrophil count is usually seen also in the percentage of neutrophils of the total WBC count. It will be below the 45%, but it is better to make the study based on the total neutrophil count.

A low neutrophil count in the blood is usually related to:

  • Infection (most common cause)
    • Bacterial: Typhoid fever, brucellosis
    • Parasites: Malaria
    • Viral (the most common of this group): Viral hepatitis, HIV, cytomegalovirus, and childhood diseases (measles, rubella, chickenpox)
  • Drugs (second most common cause)
    • Drugs often Used During Chemotherapy
    • Antithyroid drugs
    • Sulfasalazine used to treat rheumatoid arthritis
    • Clozapine used to treat schizophrenia
  • Bone marrow problems: Aplasic anemia
  • Congenital diseases: Kostmann syndrome, Chediak-Higashi syndrome

Neutropenia can be related to severe infections in elderly people or people with a weakened immune system.

Neutropenia can be present for weeks or it may be chronic. In any case, neutropenia increases the risk to suffer from an opportunistic infection because with a low neutrophil count the body cannot fight against invading pathogens.

If neutropenia is present along with fever, you probably need to find medical attention.

Neutropenia or a low neutrophil count in the blood means:

  • Mild neutropenia (1.5 - 1.8 x 103/µl in adults):

    A mild neutropenia is not a matter of concern. It may be related to excessive worry, emotional disorders or depression.

    The risk to suffer from a greater number of infections are not significant. If neutropenia persist in the following blood test, a visit to your doctor is recommended.

  • Moderate neutropenia (1 - 1.5 x 103/µl in adults):

    A moderate neutropenia increase the risk of suffering from an opportunistic infection. If fever is present, you should visit your doctor as soon as possible.

  • Marked neutropenia (0.5 - 1 x 103/µl in adults):

    A marked neutropenia is a matter of concern.

    If there is fever above 38º Celsius (above 100º Fahrenheit) in several successive captures, it must be considered a medical urgency. In that case, it is probably that you need IV (intravenous) antibiotics because the risk to suffer from an infection is very high.

  • Severe neutropenia (< 0.5 x 103/µl in adults):

    A severe neutropenia is considered a serious risk because the possibility to suffer from an opportunistic infection is very high. The situation is a serious concern if there is fever. In that case, you probably need IV (intravenous) antibiotics.

    It may be a consequence of a congenital disease, such as cyclical neutropenia, where there is a low count of neutrophils for 3 to 5 days each month, or Kostmann syndrome.

Which factors can decrease the neutrophil count in the blood?

Some particular health situation and many drugs may reduce your neutrophil count in the blood:

  • Folate deficiency
  • Vitamin B12 deficiency
  • Chemotherapy
  • Radiation therapy
  • Drugs
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Phenylbutazone
      • Penicillamine
      • Sulfasalazine
    • Antiarrhythmic agents
      • Procainamide
    • Antibiotics
      • Aminopyrine
      • Cephalosporin
      • Dapsone
      • Streptomycin
      • Methicillin
      • Metronidazole
      • Nafcillin
      • Penicillin
      • Tetracycline
      • Vancomycin
    • Antineoplastics
      • Rituximab
    • Anticoagulants
      • Dicumarol
    • Antidepressant
      • Amitriptyline
      • Chlorpromazine
      • Imipramine
      • Meprobamate
    • Antiepileptic drugs
      • Carbamazepine
      • Phenytoin
    • Antihistamine
      • Antipyretic
      • Chlorphenamine
      • Mepyramine
    • Antimalarial medication
      • Amodiaquine
      • Quinine
    • Antipyretic
      • Amidopyrine
    • Antipsychotics
      • Clozapine
      • Phenothiazines
    • Antithyroid agent
      • Carbimazole
      • Thiamazole
      • Propylthiouracil
    • Bacteriostatic agent
      • Chloramphenicol
    • Sulfonamide
      • Trimethoprim/sulfamethoxazole
    • Sulfonylureas
      • Tolbutamide

Which diseases can decrease your neutrophil count in the blood?

The following diseases can explain a neutrophil count in the blood lower than normal:

  • Viral hepatitis
  • Influenza
  • Cytomegalovirus
  • Yellow fever
  • Varicella
  • Measles
  • Mumps
  • Rubella
  • HIV Human immunodeficiency virus
  • Dengue
  • Typhoid fever
  • Brucellosis
  • Tularemia
  • Tuberculosis
  • Shigellosis
  • Malaria
  • Kala-azar
  • Rickettsiosis
  • Ehrlichiosis
  • Aplastic anemia
  • Fanconi anemia
  • Megaloblastic anemia
  • Lupus
  • Felty's syndrome
  • Chediak–Higashi syndrome
  • Kostmann syndrome
  • Cyclic neutropenia
  • Reticular dysgenesis
  • Dyskeratosis congenita
  • Benign familial chronic neutropenia
  • Barth syndrome
  • Shwachman–Diamond syndrome
  • Hairy cell leukemia
  • Griscelli syndrome
  • Cartilage-hair hypoplasia
  • Hypersplenism
  • Mononucleosis
  • Hermansky–Pudlak syndrome
  • Cohen syndrome

What can I do to increase the neutrophil count in the blood?

There is no preventive measure to avoid the decrease of neutrophils in the blood. Anyway, it is important to know that a low count of neutrophils in the blood relates to a greater risk of infection. Therefore, it is recommended:

  • To keep a good oral hygiene using antimicrobial toothpaste
  • Follow the immunization schedule
  • Wash your hands frequently

Sometimes neutropenia is treated with medication. Granulocyte colony-stimulating factor (G-CSF or GCSF) may be used to increase neutrophil count if your doctor considers it appropriate. Also, antibiotics may be effective to control infections.

Where can I find more information about neutrophil count in the blood?

You can visit our pages about:

Which values are considered a low neutrophil count in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in number of thousands/µl (microliter). They are an example of a healthy white woman of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Neutrophils
Mild neutropenia
1.7 x 103/µl1.6 x 103/µl1.5 x 103/µl     
Moderate neutropenia
1.4 x 103/µl1.3 x 103/µl1.2 x 103/µl1.1 x 103/µl1 x 103/µl   
Marked neutropenia
0.9 x 103/µl0.8 x 103/µl0.7 x 103/µl0.6 x 103/µl0.5 x 103/µl   
Severe neutropenia
0.4 x 103/µl0.3 x 103/µl0.2 x 103/µl0.1 x 103/µl0 x 103/µl   
Medically reviewed by our Medical staff on 11/02/2021

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 262.
  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 262.
  • A Manual of Laboratory and Diagnostic Test. 9th edition. Frances Fischbach. Marshall B. Dunning III. 2014. Pag 72. ISBN-10: 1451190891.
  • Laboratory tests and diagnostic procedures with nursing diagnoses (8th ed), Jane Vincent Corbett, Angela Denise Banks, ISBN: 978-0-13-237332-6, Pag. 49.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Disponible en: https://ctep.cancer.gov

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