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Immune neutropenia

Thomas D Coates, MD
Section Editor
Peter Newburger, MD
Deputy Editor
Alan G Rosmarin, MD


Neutropenia is defined as an absolute neutrophil count (ANC) of less than 1500/microL. The ANC is equal to the product of the white blood cell count (WBC) and the fraction of polymorphonuclear cells (PMNs) and band forms noted on the differential analysis:

ANC  =  WBC (cells/microL)  x  percent (PMNs  +  bands)  ÷  100

Neutrophilic metamyelocytes and younger forms are not included in this calculation (calculator 1).

Most cases of neutropenia are acquired and are due to apoptosis of myeloid cells or increased destruction [1], usually resulting from immunologic mechanisms, which can be antibody or cytotoxic-T cell related [2]. (See "Overview of neutropenia in children and adolescents" and "Approach to the adult with unexplained neutropenia", section on 'Major causes of neutropenia'.)

If the cause of the neutropenia is decreased production of granulocytes, the risk of infection begins to increase at an ANC below 500/microL (table 1).

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Literature review current through: Dec 2017. | This topic last updated: Apr 25, 2016.
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