Neutrophils mature in the bone marrowfor about 2 weeks. After entering the bloodstream, they for about 6 hours circulate in search of infectious agents and foreign substances. Finding a "victim", neutrophils migrate into tissue, are attached to these foreign agents and produce toxic substances that kill and digest them. The process is accompanied by an inflammatory response in the infected area, which is manifested by redness of the skin nadochagom inflammation, swelling and local temperature rise.
Neutrophils normally account for 48-78% of thenumber of leukocytes, so reducing the total number of leukocytes and the decrease in mean neutrophil. When the number of neutrophils falls below 1 x 109 in 1 liter of blood (less than 25% of all leukocytes), the risk of infection increases somewhat, but if the number of neutrophils is less than 0.5 x 109 in 1 L, this risk increases very significantly . Without the protection afforded by neutrophils, a person can die from the infection.
Neutropenia, along with other types of deficiencyblood cells characteristic of aplastic anemia. Reducing the number of white blood cells accompanied by some rare hereditary diseases such as infantile genetic agranulocytosis and neutropenia family.
When hereditary cyclic neutropenia,rare disease, neutrophil count fluctuates between normal and low with a period of 21-28 days; it may fall to nearly zero and then after 3-4 days to return to normal spontaneously. The likelihood of infections in patients with cyclic neutropenia hereditary increased in that period of time when the neutrophil count is low.
Neutropenia occurs in some patients withmalignant tumors, tuberculosis, myelofibrosis, a deficiency of vitamin B12 and folic acid. Some medications, especially those used in the treatment of malignant tumors (chemotherapy), the ability to break the bone marrow to produce neutrophils. Neutrophils are destroyed more rapidly than are produced when certain bacterial infections, allergic diseases, autoimmune diseases and several receiving medication. When the spleen increase (for example, Felty syndrome, malaria and sarcoidosis), neutrophil count may be reduced due to the fact that the enlarged spleen captures and destroys them.
Then establish the cause of neutropenia. Your doctor may order a bone marrow biopsy. This procedure is unpleasant, but it is not dangerous. bone marrow sample is examined under a microscope to assess its structure, the amount of production of leukocytes and neutrophil progenitor cells. After determining the number of progenitor cells, your doctor may suggest a time required to neutrophils returned to normal. If the number of progenitor cells is reduced, the new neutrophils will not appear in the bloodstream for two or more weeks; if their number is quite normal and mature cells, new neutrophils can appear in the bloodstream for several days. Sometimes the bone marrow examination indicates another disease, such as leukemia or other malignancy in blood cells.
If severe neutropenia (less than 0.5 x 109in 1 liter of blood) in patients with rapidly developing various infections because the body can not afford to fight pathogens. In such cases, patients are hospitalized and immediately prescribe strong antibiotics, even before the established cause and exact location of the focus of infection. Increased body temperature - a symptom that points to an infectious-inflammatory process, - in the presence of neutropenia is a signal to the provision of immediate medical assistance.
Sometimes there are effective growth factorsIt stimulates the production of white blood cells, particularly granulocyte colony stimulating factor (G-NWR), colony stimulating factor and granulocyte-macrophage (OM NWR). Such treatment can prevent the reduction of neutrophils at periodic hereditary neutropenia. If neutropenia is caused by an allergic or autoimmune reaction, it helps corticosteroids (hormones). Anti-thymocyte globulin, or some other drugs can be used in cases of suspected autoimmune disease to suppress immune system activity, such as aplastic anemia. If the enlarged spleen, its removal can increase the number of neutrophils.
If not provide immunosuppressive effect in patients withaplastic anemia is needed transplant (transplant) bone marrow. This operation can have significant side-effects, requires prolonged hospitalization and is performed under strict medical indications. For the treatment of neutropenia, an isolated bone marrow transplant is rarely done.