NEUTROPENIA
PSEUDO:
Neutrophil clumping (anticoagulant; paraprotein)
Marginated pool
Excess K3-EDTA
Clotted sample
TRUE:
Isolated neutropenia:
ACQUIRED:
-Infections:
Viral, Overwhelming bacterial
-Drugs:
Antibiotics (Penicillins, Cephalosporins, Chloramphenicol, Cotrimoxazole, Sulphasalazine, Imipenem)
Anti-inflammatory (Phenylbutazone, Gold)
Anti-convulsants (Phenytoin, Carbamazepine)
Anti-thyroid (Carbimazole, Methylthiouracil)
Diuretics (Hydrochlorothiazide, Frusemide, Bumetanide)
Hypoglycaemics (Chlorpropamide, Tolbutamide)
Phenothiazines (Chlorpromazine, Thioridazine)
Psychotropics (Clozapine, Mianserin, Imipramine)
Others (Deferiprone, Penicillamine)
-Immune:
Alloimmune:
Neonatal isoimmune neutropenia
Autoimmune:
Primary (Chronic idiopathic neutropenia)
Secondary (Collagen disorders; Felty's syndrome; Drugs; Viruses; Lymphoproliferative disorders e.g.
Large granular lymphocytosis; Pure white cell aplasia)
CONGENITAL:
-Cyclic neutropenia
-Maternal Hypertension
-Associated with phenotypic abnormalities:
Shwachman-Diamond-Oski syndrome
Dyskeratosis congenita
Reticular dysgenesis
Chediak-Higashi syndrome
-Associated with congenital defects:
Immunoglobulin abnormality
Defective cell-mediated immunity
Severe congenital neutropenia (Kostmann syndrome)
-Chronic benign neutropenia
Part of Pancytopenia:
Bone marrow failure
Myelodysplastic syndrome
Hypersplenism