Key messages

• Neutropenia is defined as a reduction of the absolute neutrophil count below the normal range. This is influenced by gender, age, physiological status, and ethnic origin.

• An unexpected neutropenia should always be confirmed on a blood film, which may also provide clues to the likely etiology. Bone marrow examination may be necessary when history or blood film examination do not reveal an underlying cause.

• Neutropenia occurs when neutrophil production by the marrow is outpaced by peripheral utilization or, conversely, when neutrophil survival in the peripheral circulation is decreased due to infection or immune destruction.

• The majority of acquired neutropenic states are either due to viral infections or are iatrogenic as a result of drugs. Severe bacterial sepsis can also cause neutropenia.

• Numerous genetic disorders are associated with neutropenia but represent a minority of cases seen in clinical practice.

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