Leukopenia - lower than the normal amount of white blood cells (WBCs).
- Granulocytopenia (aka agranulocytosis) is a deficiency of white bloods cell called granulocytes and results in a syndrome of frequent chronic bacterial infections of the skin, lungs, etc. Although "agranulocytosis" literally means no granulocytes, there may, in fact, be some granulocytes but too few of them, i.e. granulocytopenia. Granulocytopenia can be genetic and inherited or it can be acquired as, for example, an aspect of leukemia.
Neutrophils, eosinophils and basophils are all types of granulocytes. They are named by the staining features of their granules in the laboratory:
* Neutrophils have "neutral" subtle granules;
* Eosinophils have prominent granules that stain readily with the acid dye eosin; and
* Basophils have prominent granules that stain readily basic (nonacidic) dyes.
This classification of ganuloscytes dates to when certain structures could be identified in cells by histochemistry but the functions of the intracellular structures were still not yet understood. However, the classification of granulocytes into neutrophils, eosinophils and basophils is still widely used.
Granulocytopenia can therefore more specifically involve neutropenia (shortage of neutrophils), eosinopenia and/or basopenia. The term "neutropenia" is sometimes used interchangeably with granulocytopenia or agranulocytosis.
- Neutropenia - not enough neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis. The mature neutrophil has a segmented nucleus (it is called a seg or poly) while the immature neutrophil has band-shape nucleus (it is called a band). Neutrophils are produced in the bone marrow have a lifespan of about 3 days. Neutropenia is a serious disorder because it makes the body vulnerable to bacterial and fungal infections.
Clinically, neutropenia is defined as having occurred when the concentration of white blood cells in the blood is less than 4000 per µL. Neutropenia can develop suddenly over a few hours or days (acute neutropenia), or it can develop gradually and last for months or years (chronic neutropenia). Symptoms which patients experience depend on the level of neutropenia. The lower the neutrophil count, the greater the risk of infection. This risk increases if low neutrophil counts persist for more than three days. Types of infection include otitis media (ear infections), tonsillitis, sore throat, mouth ulcers, gum infections and skin abscesses.
Causes of neutropenia include:
* as a side effect of certain medications, such as diuretics or antibiotics
* Leukemia
* Aplastic anemia
* Radiation therapy or chemotherapy
* Some viral infections, such as mononucleosis or AIDS
* Certain bacterial infections, such as tuberculosis
* Certain autoimmune disorders, such as lupus or rheumatoid arthritis
- Eosinophilia - an absolute (compared to a relative) increase in the number of eosinophils in the circulating blood. The absolute number is obtained by multiplying the percentage of eosinophils times the white blood cell count.
Eosinophils are normally found in the bloodstream and the gut lining and contain proteins that help the body to fight infection from parasitic organisms, such as worms.
Eosinophilia occurs in a wide range of conditions. Worldwide the main cause is parasitic infection but the commonest causes in developed countries are allergic diseases such as asthma and hay fever. It can also occur in relation to common skin diseases, medicine reactions, and parasitic infections. Other rarer causes include:
* Lung diseases, eg Loeffler's syndrome
* Vasculitis (inflammation of blood vessels), eg Churg-Strauss syndrome
* Some tumours, eg lymphoma
* Liver cirrhosis
* Some antibody deficiencies; not typically AIDS
* Other rarer skin diseases, eg dermatitis herpetiformis
* Uknown causes, labelled hypereosinophilic syndrome.
Eosinophilia may be primary or secondary. In primary eosinophilia, the increased production of eosinophils is due to an abnormality in a hematopoietic stem cell as, for example, in eosinophilic leukemia. In secondary eosinophilia, the increased production of eosinophils is a reactive process driven by cytokines, as is the case in allergy.
Hypereosinophilic syndrome is a rare condition where there is no apparent cause for eosinophilia and can affect the heart, resulting in heart failure with breathlessness and ankle swelling, cause enlargement of the liver and spleen, resulting in swelling of the abdomen, and give rise to skin rashes.
The symptoms of eosinophilia are those of the underlying condition. For example, eosinophilia due to asthma is marked by symptoms such as wheezing and breathlessness, whereas parasitic infections may lead to abdominal pain, diarrhoea, fever, or cough and rashes. Medicine reactions often give rise to skin rashes, and they often occur after taking a new drug. Rarer symptoms of eosinophilia can include weight loss, night sweats, lymph node enlargement, other skin rashes, and numbness and tingling due to nerve damage.
