Neutropenia (low neutrophil count)
Medically reviewed on January 11, 2018
Neutropenia (noo-troe-PEE-nee-uh) is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell important to fighting off infections — particularly those caused by bacteria.
For adults, counts of less than 1,500 neutrophils per microliter of blood are considered to be neutropenia. For children, the cell count indicating neutropenia varies with age.
Some people have lower-than-average neutrophil counts, but not an increased risk of infection. In these situations their neutropenia isn't a concern. Neutrophil counts less than 1,000 neutrophils per microliter — and especially counts of less than 500 neutrophils per microliter — are always considered to be neutropenia, where even the normal bacteria from your mouth and digestive tract can cause serious infections.
Cancer chemotherapy is probably the most common cause of neutropenia. People with chemotherapy-related neutropenia are prone to infections while they wait for their cell counts to recover.
Neutrophils are manufactured in bone marrow — the spongy tissue inside some of your larger bones. Anything that disrupts neutrophil production can result in neutropenia.
Specific causes include:
- Chronic idiopathic neutropenia in adults
- Kostmann's syndrome (a congenital disorder involving low production of neutrophils)
- Leukemia and other diseases that damage bone marrow
- Myelodysplastic syndromes
- Myelofibrosis (a bone marrow disorder)
- Myelokathexis (a congenital disorder involving failure of neutrophils to enter the bloodstream)
- Radiation therapy
- Vitamin deficiencies
Certain infections also can result in neutropenia, including:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Lyme disease
- Other viral infections that disrupt the work of bone marrow
- Salmonella infection
- Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
Conditions that destroy neutrophils in the bloodstream and that can result in neutropenia include:
- Hypersplenism (an abnormality of the spleen causing blood cell destruction)
- Medications, such as antibiotics
- Rheumatoid arthritis and other autoimmune disorders
When to see a doctor
Neutropenia is usually found when your doctor orders tests for a condition you're already experiencing. It's rare for neutropenia to be discovered unexpectedly or by chance.
Talk to your doctor about what your test results mean. Neutropenia and results from other tests might indicate the cause of your illness. Or, your doctor may suggest other tests to further check your condition.
Because neutropenia makes you vulnerable to bacterial and fungal infections, your doctor will probably advise certain precautions. These often include wearing a face mask, avoiding anyone with a cold, and washing your hands regularly and thoroughly.