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Approach to the adult with unexplained neutropenia

Nancy Berliner, MD
Section Editor
Peter Newburger, MD
Deputy Editor
Alan G Rosmarin, MD


Neutrophils are mature granulocytic white blood cells (WBC) that defend against infection. Neutropenia is an abnormally low number of circulating neutrophils, which is based on a calculated number from a complete blood count (CBC). (See 'Terminology and definition of neutropenia' below.)

The implications of neutropenia vary widely, from a risk of potentially life-threatening infections in drug-induced neutropenia to a benign finding with essentially no clinical implications in individuals with benign ethnic neutropenia. Thus, it is important to determine the cause of neutropenia, and the associated infectious (and other) risks, so that the patient can be appropriately managed and educated about his/her condition.

This topic will discuss our approach to the evaluation of the adult patient with unexplained neutropenia as a predominant feature of the CBC. The approach to the patient with neutropenia in the setting of other major cytopenias (eg, anemia, thrombocytopenia) is discussed separately. (See "Clinical manifestations and diagnosis of the myelodysplastic syndromes" and "Aplastic anemia: Pathogenesis, clinical manifestations, and diagnosis".)

The management of non-chemotherapy-induced neutropenia is presented separately. (See "Management of the adult with non-chemotherapy-induced neutropenia" and "Overview of neutropenia in children and adolescents", section on 'General aspects of treatment'.)

Fever in a patient who is neutropenic due to chemotherapy, hematopoietic cell transplant, or bone marrow suppression from any cause is a medical emergency. This issue is discussed separately. (See "Overview of neutropenic fever syndromes".)

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Literature review current through: Nov 2017. | This topic last updated: Oct 03, 2016.
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