What Is Granulocytopenia?

Various reasons cause the peripheral blood leukocyte count to be continuously lower than 3.5 × 10 ⁹ / L, which is called leukopenia. The absolute value of peripheral blood neutrophils in adults is less than 2 × 10 ⁹ / L, which is called neutropenia. Neutrophils are below 0.5 × 10 ⁹ / L, which is called agranulocytosis.

Basic Information

English name

granulocytopenia

Visiting department

Internal medicine

Common causes

1. Generate defects; 2. Excessive damage or consumption; 3. Abnormal distribution

Common symptoms

Sudden onset of symptoms with severe infections

Causes of granulocytopenia

The growth of neutrophils in bone marrow can be divided into stem cell pools, division pools, and storage pools. Mature neutrophils are mostly stored in the bone marrow and can be released into the blood at any time. After entering the blood, half of the neutrophils are attached to the small vessel wall, called the marginal pool, and the other half are in the blood circulation, called the circulation pool. Neutrophils have a short half-life in peripheral blood, 6 to 7 hours, and then enter tissues. There are many reasons for neutropenia, and the pathogenesis is complicated. There are three clinical types:

Neutrophil defect

(1) Cytotoxic drugs, chemical poisons and radiation: the most common causes.

(2) Infection and abnormal immunity: some bacterial, viral, rickettsiae or protozoan infections.

(3) Bone marrow abnormal cell infiltration: leukemia, lymphoma bone marrow invasion, metastatic cancer, etc.

(4) Bone marrow failure diseases: aplastic anemia, paroxysmal nocturnal hemoglobinuria, etc.

(5) A variety of congenital neutropenia: the specific mechanism is unknown.

(6) Impaired neutrophil maturation: folic acid, vitamin B ₁₂ deficiency, myelodysplastic syndrome, etc.

2. Neutrophil destruction or excessive consumption

(1) Immune factors Various autoimmune diseases and certain infections such as chronic hepatitis.

(2) Non-immune factors include severe bacterial infection, sepsis, viral infection, or hypersplenism.

3. Abnormal neutrophil distribution

Certain allogeneic protein reactions and endotoxemia can cause neutrophils to transfer to the marginal pool. When the spleen is enlarged, the granulocytes remain in the spleen.

Diagnosis of granulocytopenia

1. Often have a history of infection, physical and chemical contact, medication, immune factors and other medical history.

2. When the granulocyte is deficient, the onset is rapid and severe infection symptoms may occur.

3. Blood routine: The number of white blood cells is reduced, the number of neutrophils is reduced, and the ratio of lymphocytes is relatively increased. According to the degree of neutrophil reduction, it can be divided into mild (1.0 × 10 ⁹ / L), moderate (0.5 1.0 × 10 ⁹ / L), and severe (<0.5 × 10 ⁹ / L).

(4) Myelogram: no specific changes.

Granulocytopenia treatment

Cause treatment

Identify the cause and actively treat the primary disease. If it is caused by drugs, suspicious drugs such as antibiotics and antipyretic drugs should be stopped.

2. Prevent infection

Mild neutropenia does not require special preventive measures. Those with moderate reductions have an increased chance of infection, reduce access to public places, pay attention to skin, oral cavity, and respiratory hygiene, and remove chronic infections. People with agranulocytosis should take isolation measures to prevent cross infection. Infected persons should be cultured for pathogenic bacteria to identify the location and type of infection. Before the pathogens are unclear, they should be treated with broad-spectrum, high-efficiency and sufficient antibiotics empirically, and pay attention to fungal infections.

3. Symptomatic and whitening treatment

Shaver alcohol, Lixuesheng, and granulocyte deficiency can be treated with granulocyte colony-stimulating factor.