Saturday, May 22, 2010

Neutropenia summary

Neutropenia is an abnormally low count of neutrophils in the blood. Neutrophils are white blood cells that protect our body from bacteria and fungus infection. Neutrophils usually constitute about 45 to 75% of all white blood cells in the bloodstream.

Severity of neutropenia relates to the relative risk of infection:

  • Mild (1000 to 1500/μL)
  • Moderate (500 to 1000/μL)
  • Severe ( 500/μL)
[Source: Merck].

A blood lab test is used to diagnose neutropenia.

Causes

- chemo or radiotherapy, autoimminue disorder, spleen disorder, infections or vitamin B deficiencies (B12 & folic acid)

- drug-induced

The incidence of drug-induced neutropenia is 1 case per million persons per year.
List of drugs that could cause neutropenia, excluding cytotoxic agents:

amiodarone
allopurinol
azothioprine
*carbamazepine
co-trimoxazole
*clomipramine
captopril, enalapril
dipyrone
mirtazapine
NSAIDs
phenytoin
*propyl thiouracil (anti-thyroid meds) - usually occurs in the first 3 mths
*procainamides
*psychotropic drugs (clozapine...)
*sulphasalazine
sulphonylurea derivatives
ticlopidine
quinidine
macrolides, sulphonamides and some other antibiotics

[More]

*higher probability

Discontinuation of the drug generally results in correction of the neutrophil count within 30 days.

Signs and symptoms

Fever (>3days in adult), sorethroat, mouth ulcers, frequent infections

See Medscape about treatments -->

Monitor

signs of infection & CBC count

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