Acquired neutropenia

Acquired neutropenia is a condition characterized by an abnormally low number of neutrophils (a type of white blood cell essential for fighting infections) in the blood, where the neutrophil count falls below 1,500 cells per microliter. Unlike congenital or inherited forms of neutropenia, acquired neutropenia develops after birth due to external or secondary causes. It can affect individuals at any age and may be acute or chronic in nature. The condition primarily impacts the immune system, leaving affected individuals vulnerable to bacterial and fungal infections, particularly of the skin, mucous membranes, gums, and respiratory tract. Acquired neutropenia can arise from a wide range of causes, including medications (such as chemotherapy agents, certain antibiotics, antithyroid drugs, and anticonvulsants), autoimmune disorders (where antibodies target and destroy neutrophils), viral infections (including HIV, hepatitis, and Epstein-Barr virus), nutritional deficiencies (particularly vitamin B12, folate, or copper deficiency), bone marrow infiltration by malignancies, or overwhelming sepsis. Autoimmune neutropenia is a notable subtype, particularly common in infants and young children, where autoantibodies directed against neutrophil surface antigens lead to accelerated neutrophil destruction. Key symptoms include recurrent infections, fever, mouth ulcers (oral stomatitis), gingivitis, skin abscesses, and in severe cases, life-threatening sepsis. The severity of clinical manifestations generally correlates with the degree of neutropenia: mild neutropenia (1,000–1,500 cells/μL) may be asymptomatic, while severe neutropenia (below 500 cells/μL) carries a high risk of serious infections. Treatment depends on the underlying cause and severity. Management strategies include identifying and removing offending agents, treating underlying conditions, administering granulocyte colony-stimulating factor (G-CSF) to stimulate neutrophil production, and using prophylactic antibiotics in severe cases. In many instances, particularly drug-induced or autoimmune neutropenia in children, the condition is reversible once the causative factor is addressed.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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