Neutropenia: Causes, Symptoms & Treatment

What are Normal Neutropenia Levels?

Neutrophils account for about 55%-70% of all white blood cells. In a healthy person, the normal range for neutrophils is between 2,500 and 6,000 per microliter of blood. If you’re blood has a neutrophil level lower than 1,500, then you have neutropenia. This is classified into 3 types based on the number of neutrophils. These are:

Classification Neutrophil Count (/μL)Mild 1,000 to 1,500Moderate 500 to 1,000Severe <500

Neutropenia can be further classified by its duration and cause into four types:

• Congenital - Present from birth
• Acquired - Developed later in life
• Acute - Occurs suddenly and is typically short-term
• Chronic - Persists for longer than three months

Mild or low-level neutropenia is usually not a cause for concern. Many individuals with this condition may not experience any symptoms or need treatment. However, when neutropenia becomes moderate or severe, symptoms may begin to appear, and medical intervention is often necessary.

What are the Causes of Neutropenia?

Neutropenia happens when your body doesn't have enough neutrophils.

This can happen when:

• Your bone marrow doesn't make enough neutrophils
• The neutrophils break down too quickly, or
• The body destroys them faster than they are produced

Any of the following can lead to neutropenia:

• Infections: Viral or severe bacterial infections can reduce neutrophil production or increase their usage.
• Medications: Drugs like chemotherapy, antibiotics, and immunosuppressants may suppress bone marrow or destroy neutrophils.
• Autoimmune Diseases: Conditions like lupus or rheumatoid arthritis can cause the immune system to attack neutrophils.
• Nutritional Deficiencies: Lack of Vitamin B12, folate, or copper affects the body’s ability to produce neutrophils.
• Bone Marrow Disorders: Diseases like leukemia or aplastic anemia reduce the marrow’s ability to make white blood cells.
• Genetic Conditions: Some people are born with disorders (e.g., Kostmann syndrome) that affect neutrophil production.
• Overactive Spleen: The spleen may trap or destroy too many neutrophils in certain conditions.
• Radiation or Toxins: Exposure can damage the bone marrow and lower neutrophil count.
• Idiopathic (Unknown Cause): Sometimes, the exact cause of neutropenia can’t be identified.

What are the Symptoms of Neutropenia?

Neutropenia itself may not cause noticeable symptoms, especially if it's mild. However, when neutrophil levels are very low, the risk of infection increases, and you may notice signs of infection such as:

• Fever or chills (even a low-grade fever can be serious)
• Frequent infections (e.g., throat, skin, lungs, or urinary tract)
• Sore throat or mouth ulcers
• Swollen or painful gums
• Fatigue or weakness
• Pain or burning during urination
• Cough, shortness of breath, or chest pain
• Redness, warmth, or swelling around wounds

In people with severe neutropenia, even minor infections can become serious quickly. A fever in someone with neutropenia should always be treated as a medical emergency.

How to Diagnose Neutropenia?

Primarily, neutropenia is diagnosed through a complete blood test with differential. If you’re undergoing some treatment, where it can reduce the level of neutropenia, such as chemotherapy, your doctor may advise you to do regular screening.

Your healthcare provider may recommend some additional tests, such as a bone marrow biopsy, to confirm the underlying cause of neutropenia.

What Treatments are Available for Neutropenia?

Following are the types of treatments available for neutropenia:

1. Antibiotics

If you have a fever along with neutropenia (called febrile neutropenia), you may need to stay in the hospital. You'll get antibiotics through a vein (IV) to treat or prevent serious infections.

2. Corticosteroids

If neutropenia is caused by your immune system attacking your own cells (autoimmune), your doctor may prescribe steroids to reduce this immune response.

3. G-CSF Injections (Growth Factor)

This medication helps your bone marrow make more white blood cells. It’s often given if you're receiving chemotherapy and your white blood cell count drops.

4. Changing Medications

Sometimes, neutropenia happens due to a side effect of a drug you're taking. Your doctor may stop or adjust the dose of that medicine.

5. Supplements (if needed)

If neutropenia is caused by deficiencies in vitamin B12, folate, or copper, your doctor may recommend supplements.

6. Bone Marrow Transplant

In rare, severe, or inherited cases, a bone marrow or stem cell transplant may be recommended.

Always follow your doctor’s advice. Early treatment helps reduce the risk of serious infections.

Also Read:- Bone Marrow Transplant Cost in India

How to Prevent Neutropenia?

You can’t prevent it if you’re born with this. If some medications or treatments such as chemotherapy are affecting your neutropenia, then you’re healthcare provider may delay up to the next round or reduce the dose.

If you’re already affected by neutropenia and want to prevent yourself from infection, you should follow the instructions given below:

• Regularly wash your hands with soap or alcohol-based sanitizer
• Avoid crowded places and try to wear a mask if needed
• Stay away from people who are sick
• Keep your home and surroundings clean
• Brush your teeth gently every day
• Eat only well-cooked food (avoid raw meat, eggs, seafood)
• Take all medicines as prescribed by your doctor
• Watch for signs of infection (fever, sore throat, etc.)
• Ask your doctor which vaccines are safe for you

Also Read:- Best Hospitals in India

Key Takeaways

Neutropenia lowers your body's ability to fight infections due to reduced white blood cells. While it can be mild and symptomless, severe cases need attention. With timely diagnosis, treatment, and basic precautions, neutropenia is manageable—and most people can lead healthy, active lives.