Neutropenia is a blood disorder characterized by an unnaturally low level of neutrophils. The latter are one of the most common types of white blood cells and they play a vital role in a person’s ability to fight off infections, especially those that are bacterial in nature. Adults should have a minimum of 1500 neutrophils in each microliter of blood. Levels running lower than this may indicate the presence of neutropenia. For youngsters, the parameters for the disease vary with age.
Some individuals have lower than average neutrophil counts throughout their entire life; however, they never experience an increased risk of bacterial infections and their condition never becomes a cause for serious concern. Nevertheless, anyone with a neutrophil count of less than 500 neutrophils per microliter is usually diagnosed with neutropenia and monitored for complications. In such individuals, even normal bacteria from the digestive tract or mouth can lead to serious or even life-threatening infections.
1. Fever
Neutropenia itself is often asymptomatic, meaning it does not cause any symptoms at all. In certain instances, individuals only discover they have the disorder when they undergo diagnostic procedures–such as certain blood tests–for unrelated reasons. However, other people have many signs and symptoms. Of all symptoms of the disorder, fever is believed by many physicians to be the most common. In some cases a person may run a low-grade fever on a continuous basis, while others experience high fevers on and off over several weeks, months or years.
In most cases: however, this type of fever manifests as a temperature of approximately 101°Fahrenheit that is sustained for an hour or more. In almost all instances, it is a symptom of an infection, whether viral or bacterial, that was ultimately caused by the neutropenia.
2. Mouth Ulcer
Because most infections caused by neutropenia occur in the mouth, it is not uncommon for patients of this disorder to develop mouth ulcers, specifically, aphthous ulcers. These often have the appearance of a tiny hole or crack on the inside of the cheek, under the tongue or along the gum line. In rare cases, a mouth ulcer may be found on the roof of the mouth or on the top of the tongue, but most prefer the environment of softer mucous membranes. Aphthous ulcers are categorized as herpetiform, major or minor. Herpetiform and minor aphthous ulcers generally heal within ten days, but due to their size, major ones may take much longer and may also eventually develop a necrotic appearance.
3. Sore Throat
A sore throat may also indicate the presence of neutropenia and it is the second most common symptom of the disease. In some cases, this symptom may be quite mild in nature, and a person may assume that he or she is simply fighting off a cold or other minor illness. It is not uncommon for someone who is experiencing a sore throat to notice swollen tonsils as well. The back of the throat may have a bright red appearance that is more obvious on one side than the other, or the person’s throat may be sore without any swelling or redness.
4. Susceptibility to Infection
Susceptibility to infection is another symptom of neutropenia, as neutrophils play an important role in fighting infection and supporting the human immune system. Neutrophils are designed to specifically fight bacterial infections, and therefore those with the disorder may easily become ill from contact with bacteria. However, viral infections may occur as well, as neutrophils also support one’s immune system overall. Susceptibility to infection may be low or high, depending on the severity of the neutropenia. For example, with mild cases of the disorder, a person may not become ill on a frequent basis, while severe cases place him or her at an ongoing serious risk for major infections.
5. Neutrophils in the Blood
A person’s neutrophil levels are the most specific way to test for the presence of neutropenia. Those suffering from the disorder typically do not have enough neutrophils in the blood, thus leading to the aforementioned symptoms, such as a high risk for infection. In most cases, if the neutrophils in a person’s bloodstream measure less than 1000 per microliter, he or she will be cautioned about possible future infections, as a neutrophil measurement of this kind indicates a weakened immune system. Some laboratories complete a test called an “absolute neutrophil count,” which is usually more distinct than the measurement of neutrophils completed during a standard blood count.
6. Skin Infections
All types of skin infections are associated with neutropenia. These may come in the form of body rashes, isolated skin lesions or open sores that heal very slowly or that do not heal at all. Unfortunately, these skin infections are sometimes treated as a dermatological issue rather than a systemic issue: rashes caused by systemic disorders or autoimmune disorders are not the allergy-based rashes seen with problems directly related to the skin. Additionally, diabetics may be misdiagnosed as simply having a cut or abrasion that is slow to heal due to diabetes, rather than an underlying condition.
7. Low-Grade Fever
A low-grade fever is sometimes a sign of neutropenia and is considered one that hovers around 100.4°Fahrenheit or lower, but never quite reaches a normal temperature of 97.6° to 98.6° Fahrenheit. This symptom often goes undetected, particularly if it is lower than 100° Fahrenheit. This is because it is simply not high enough to cause some of the symptoms associated with a high fever, such as a flushed appearance, chills or headache. A low-grade fever is typically a sign that the person’s body is fighting off weak germs or infections that are not particularly serious.
8. Mouth Sores
In addition to the ulcers previously mentioned, neutropenia can cause a broad range of mouth sores as well. These include canker sores, blisters that resemble a burn, cold sores, and even sores that resemble measles. A person may at first notice a sore that appears to be a blister, but he or she does not remember experiencing a burn to the mouth, such as type that occur when one consumes food or beverages that are too hot. Mouth sores associated with neutropenia may or may not bleed, and may take a long time to heal, depending on the severity of the disorder.
9. Swollen Gums
A less common, but distinct symptom of neutropenia is swollen gums. These may occur on a chronic or acute basis, and often appear suddenly. In some cases, the gums are also red and inflamed, but swelling alone is quite common as well. In many instances, swollen gums occur simultaneously with mouth sores or ulcers, and therefore may be mistaken for some type of dental or gum disorder as opposed to an underlying systemic condition. Regardless of which symptom a person may be experiencing, however, anyone who notices one or more signs of neutropenia should seek the advice of a licensed medical professional.
