Neutropenia

Resident’s Name: Chad Abby Date: 5/13/2009
Neutropenia:
Neutropenia is a hematological disorder characterized by an abnormally low number of a type of white blood cell called a neutrophil. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defense against infections by destroying bacteria in the blood. Hence, patients with neutropenia are more susceptible to bacterial infections and, without prompt medical attention, the condition may become life-threatening. A patient has chronic neutropenia if the condition lasts for longer than 3 months. It is sometimes used interchangeably with the term leukopenia. There are three general guidelines used to classify the severity of neutropenia based on the absolute neutrophil count (ANC) measured in cells per microliter of blood:
Mild neutropenia (1000 <= ANC < 1500) — minimal risk of infection
Moderate neutropenia (500 <= ANC < 1000) — moderate risk of infection
Severe neutropenia (ANC < 500) — severe risk of infection
Some common symptoms of neutropenia include fevers and frequent infections. These infections can result in conditions such as mouth ulcers, diarrhea, a burning sensation when urinating, unusual redness, pain, or swelling around a wound, or a sore throat. Causes can be divided into the following groups:
Decreased production in the bone marrow:
aplastic anemia
cancer, particularly blood cancers
certain medications
hereditary disorders (e.g. congenital neutropenia, cyclic neutropenia)
radiation
Vitamin B12 or folate deficiency.
Increased destruction:
autoimmune neutropenia.
chemotherapy treatments, such as for cancer and autoimmune diseases
Marginalisation and sequestration:
Hemodialysis
There is often a mild neutropenia in viral infections.
People with neutropenia are sometimes given antibiotics before they have major dental treatment. This helps protect them from infections. Generally, if your neutrophil count is less than 1,000, you will need antibiotics. Sometimes you may have to take the antibiotics for several days after treatment as well. If you have neutropenia or are taking medicines that can cause neutropenia, give your dentist an updated copy of your blood test results every time you visit.If there is a history of neutropenia or any of the conditions are occurring as expressed above then a blood test should be ordered before starting any dental treatment. According to hospital protocol any non-routine orders must be ordered by the child’s physician. It is necessary that you work closely with the child’s physician to avoid any unnecessary possible life threatening conditions.