Neutropenia (न्यूट्रोपेनिया): Causes, Symptoms, Diagnosis & Treatment

 

Neutropenia (न्यूट्रोपेनिया): Causes, Symptoms, Diagnosis & Treatment

Introduction | परिचय

Neutropenia is a medical condition characterized by a decreased number of neutrophils in the blood. Neutrophils are a type of white blood cell that play a crucial role in defending the body against bacterial and fungal infections.

When neutrophil levels drop significantly, the body becomes more susceptible to infections, which may sometimes become life-threatening if not treated promptly.

न्यूट्रोपेनिया वह स्थिति है जिसमें रक्त में न्यूट्रोफिल (Neutrophils) की संख्या सामान्य से कम हो जाती है। न्यूट्रोफिल सफेद रक्त कोशिकाओं का एक महत्वपूर्ण प्रकार हैं जो शरीर को बैक्टीरिया और फंगल संक्रमणों से बचाने में मदद करते हैं।

जब इनकी संख्या कम हो जाती है, तो शरीर में संक्रमण का खतरा बढ़ जाता है।

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Normal Neutrophil Count | सामान्य न्यूट्रोफिल स्तर

Severity	ANC (Absolute Neutrophil Count)
Normal	1500 – 8000 /µL
Mild Neutropenia	1000 – 1500 /µL
Moderate Neutropenia	500 – 1000 /µL
Severe Neutropenia	< 500 /µL

ANC Formula:
ANC = Total WBC × (% Neutrophils + % Bands) / 100

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Causes of Neutropenia | न्यूट्रोपेनिया के कारण

1. Infections

Many viral and bacterial infections can suppress bone marrow temporarily.

Examples:

• Dengue

• HIV infection

• Hepatitis viruses

• Tuberculosis

• Severe bacterial sepsis

संक्रमण
कई वायरस और बैक्टीरिया अस्थि मज्जा (Bone marrow) को प्रभावित कर सकते हैं।

उदाहरण

• डेंगू

• HIV

• हेपेटाइटिस

• टीबी

• गंभीर बैक्टीरियल संक्रमण

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2. Drug-Induced Neutropenia

Several medications can suppress bone marrow.

Common drugs:

• Chemotherapy drugs

• Antithyroid drugs (Carbimazole, PTU)

• Antibiotics (Chloramphenicol)

• Antipsychotics (Clozapine)

दवाओं से होने वाला न्यूट्रोपेनिया
कुछ दवाएँ बोन मैरो को दबा सकती हैं।

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3. Bone Marrow Disorders

Diseases affecting bone marrow reduce neutrophil production.

Examples:

• Aplastic anemia

• Leukemia

• Myelodysplastic syndrome

• Bone marrow infiltration

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4. Nutritional Deficiencies

Certain deficiencies impair blood cell production.

• Vitamin B12 deficiency

• Folic acid deficiency

• Copper deficiency

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5. Autoimmune Disorders

In some diseases, the immune system destroys neutrophils.

Examples:

• Systemic lupus erythematosus (SLE)

• Rheumatoid arthritis

• Felty syndrome

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6. Hypersplenism

An enlarged spleen may trap and destroy neutrophils.

Causes include:

• Liver cirrhosis

• Portal hypertension

• Hematological disorders

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Symptoms of Neutropenia | न्यूट्रोपेनिया के लक्षण

Neutropenia itself may not cause symptoms, but infections appear easily.

Common symptoms include:

• Fever (most important sign)

• Recurrent infections

• Mouth ulcers

• Sore throat

• Skin infections

• Pneumonia

• Sepsis in severe cases

मुख्य लक्षण

• बुखार

• बार-बार संक्रमण

• मुंह में छाले

• गले में दर्द

• त्वचा संक्रमण

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Diagnosis | निदान

Diagnosis involves clinical evaluation and laboratory tests.

1. Complete Blood Count (CBC)

Shows reduced neutrophil count.

2. Peripheral Blood Smear

Helps identify abnormal cells.

3. Bone Marrow Examination

Indicated if marrow failure or malignancy is suspected.

4. Infection Screening

• Blood culture

• Viral markers

• Tuberculosis tests

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Complications | जटिलताएँ

Severe neutropenia may lead to serious infections such as:

• Septicemia

• Pneumonia

• Fungal infections

• Life-threatening sepsis

Patients with ANC <500 require urgent medical attention.

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Treatment | उपचार

Treatment depends on the underlying cause.

1. Treat the underlying disease

Examples:

• Antiviral therapy

• Antibiotics for bacterial infection

• Stop offending drugs

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2. Granulocyte Colony-Stimulating Factor (G-CSF)

Drugs like Filgrastim stimulate neutrophil production.

Used in:

• Chemotherapy-induced neutropenia

• Severe neutropenia

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3. Antibiotics

Broad-spectrum antibiotics are started immediately if fever develops.

This condition is called Febrile Neutropenia, which is a medical emergency.

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4. Nutritional Therapy

Correction of:

• Vitamin B12 deficiency

• Folic acid deficiency

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Prevention | बचाव

Patients with neutropenia should:

• Maintain good hygiene

• Avoid crowded places during severe neutropenia

• Eat well-cooked food

• Avoid raw or contaminated food

• Monitor fever carefully

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When to Seek Medical Help | डॉक्टर से कब संपर्क करें

Immediate medical attention is required if:

• Fever above 38°C

• Persistent sore throat

• Mouth ulcers

• Recurrent infections

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Conclusion | निष्कर्ष

Neutropenia is an important hematological condition that significantly increases the risk of infections. Early diagnosis, identification of the underlying cause, and prompt treatment can prevent serious complications.

Proper monitoring of ANC levels and timely medical intervention is essential for better patient outcomes.

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✅ Dr. Kamlesh Agrawal
MD Medicine | FICP | FIMA | FRCP
Radha Krishna Critical Care Hospital, Kota