Idiopathic adult neutropenia
Neutropenia: Reduced number of granulocytes in the blood.
Fever Sore throat Painful mouth ulcers Anal ulcers Reduced immune response
The follow list shows some of the possible medical causes of Neutropenia that are listed by the Diseases Database: Imatinib mesylate Docetaxel Oklahoma tick fever Pentamidine Deferiprone Hydroxycarbamide Sulphasalazine Isoniazid Ethotoin Valganciclovir Procainamide Caspofungin Clozapine Chediak-Higashi disease Mirtazapine Sulphonamides Barth syndrome Autoimmune lymphoproliferative syndrome type 1 Griscelli syndrome type 1 Bevacizumab Propionyl-CoA carboxylase deficiency
Treatments vary with the severity of neutropenia and the pattern of susceptibility to infection. With few exceptions, use of corticosteroids, immunosuppressive drugs, g-globulin injections, androgens, and splenectomy is rarely helpful. The neutropenia in Felty's syndrome often responds to splenectomy as well as to weekly doses of methotrexate. Granulocyte colony stimulating factor (G-CSF) Granulocyte-macrophage colony stimulating factor (GM-CSF) 1. Treat underlying cause if possible 2. G-CSF: Filgrastim (Neupogen) - For febrile neutropenia: Adults dosage is 5—10 µg/kg IV or SC once daily is sufficient to support the Absolute Neutrophil Count during an episode of febrile neutropenia. - For the treatment of congenital, idiopathic, and cyclic neutropenia and hastens the recovery of marrow from neutropenia after cancer chemotherapy: the usual dose of 1 to 5 ug/kg/day, is of proven benefit . 3. GM-CSF: Sargramostim (Leukine) : Higher incidence of severe side effects compared with G-CSF; No apparent clinical benefit over G-CSF. 4. Glucocorticoids may be effective in some conditions 5. B12 and/or folic acid may improve counts 6. Treatment of Febrile Neutropenic Patients: Specific guidelines have been developed (see below) ; Main concern are gram negative (G-) enteric organisms; G- organisms likely seed from gut due to microperforations; Staphylococci and enterococci also concerning; Prolonged neutropenia associated with fungal infections and also herpesvirus eruptions