Approach to Neutrophilia and Neutropenia (2)

Question 1

Neutrophilia:
What are its more common cause?

What are its less common causes?

Answer 1

➊ • Bacterial infection
• Severe stress e.g. trauma, surgery, burns, seizures
• Active inflammation e.g. MI, disseminated malignancy

➋ • Corticosteroids
• Myeloproliferative disease (myelofibrosis, polycythaemia vera)

Question 2

Neutropenia:
What are the causes if isolated?

When is it called agranulocytosis?
→ What are some causes of this?

What’s the regimen to follow when treating these pts?

Answer 2

➊ • Viral infections
• Severe sepsis
• Bone marrow failure
• Neutrophil antibodies e.g. SLE, Haemolytic anaemia

➋ When associated with depleted levels of basophils and eosinophils
→ Carbamazepine, Carbimazole, Clozapine

➌ • Isolation
• Look for any source of infection
• Avoid IM injections
• Bloods - FBC, U&E, CRP, Platelets, INR, LFT, Cultures