Neutropenia: Classification of Neutropenia.
This desease is a granulocyte disorder characterized by an abnormally low number of nentrophils. Neutrophils usually make up to 50-70% of circulating white blood cells. Hence, patients with neutropenia are more susceptible to bacterial infections and, without prompt medical attention, the condition may become life-threatening (neutropenic sepsis).
It can be acute or chronic depending on the duration of the illness. It is chronic if condition lasts for longer than 3 months, it is sometimes used interchangeably with the term leucopenia “deficit in the number of WBCs”.
Classification of Neutropenia.
There are general guidelines used to classify the severity of neutropenia-based on the absolute neutrophil count (ANC) measured in cell per microliter of blood (Hsieh et al., 2007).
- Mild-neutropenia (1000 ≤ ANC < 1500) minimal risk infection
- Moderate neutropenia (500 ≤ ANC < 1000) moderate risk of infection
- Severe neutropenia (ANC < 500) severe risk of infection.
Note: A large proportion of healthy African have been observed to have a white blood cell count (WBC) that is persistently lower than the normal range defined for individuals of European ancestry . This condition called “Benign Ethnic Neutropenia” (BEN). BEN can have important effect on medical decision making, since WBC is a valuable indicator of immunocompetence, infection and inflammation. The etiology of BEN is not well understood, but the mechanism for it does not appear to represent a biological abnormality.
About half of the neutrophils in blood, circulate to form circulating pool (included in WBC count) while the other half migrate along the walls of the blood vessels and capillaries, forming marginated pools (not included in WBC count). Increased number of neutrophil in the marginating pool may explain the lower circulating neutrophil count in Africans (Monica, 2000).