Autoimmune neutropenia is a blood disorder where a person’s antibodies attack and destroy their own neutrophils, causing a decrease in the number of these cells. This can lead to increased susceptibility to infections, and treatment varies depending on severity. Diagnosis requires a complete blood count and may also require a bone marrow test. Some people may have a spontaneous remission, while others may require treatment with white blood cell growth factors. Lifestyle changes to reduce the risk of infection are important.
Autoimmune neutropenia (AIN), also known as autoimmune leukopenia or autoimmune granulocytopenia, is a blood disorder in which a person’s antibodies attack and destroy their own neutrophils, causing a decrease in the number of these cells. Neutrophils are a type of white blood cell, or leukocyte, that helps the body fight infection. Neutropenia is the general term for a decrease in neutrophil count, regardless of the cause of this state. Patients with a low neutrophil count are more prone to infections and can become very ill. The treatment needs of people with neutropenia vary depending on the severity of the neutropenia.
Reaching a diagnosis of autoimmune neutropenia requires a complete blood count and may also require a bone marrow test. To make a diagnosis of neutropenia in general, a blood sample is taken and the white blood cells in the sample are counted. Then, the percentage of neutrophils in the white blood cells is determined by a procedure called a differential white blood cell analysis. This results in a number called the absolute neutrophil count (ANC), which must be less than 1500 neutrophils per microliter of blood for a diagnosis of neutropenia.
Once neutropenia has been established, the cause has yet to be determined. Making a diagnosis of autoimmune neutropenia can be difficult because the antibodies that are attacking the neutrophils may not be easy to find. A bone marrow test may be conducted to rule out the possibility of other types of neutropenia where not enough neutrophils are created in the marrow. In autoimmune neutropenia, enough neutrophils are created, but these cells are killed prematurely by neutrophil-specific antibodies.
Autoimmune neutropenia can be mild, moderate, or severe. Some people with autoimmune neutropenia, particularly very young children, will have a spontaneous remission of the condition after a couple of years and may never need any treatment. This spontaneous remission is less likely in older children and adults, who will likely have the condition for life, although it may never cause significant problems.
People with autoimmune neutropenia are more susceptible to infections because the body can’t fight off invading cells effectively. Many patients will experience only slightly increased susceptibility, and these patients will only need antibiotics and similar treatments when an infection is present. Other patients may suffer from severe or chronic infections, in which case treatment with white blood cell growth factors may be required to restore the white blood cell count to a stable level. Making lifestyle changes to reduce the risk of infection is important for people with all types of neutropenia, such as paying special attention to hygiene, avoiding sick people, and maintaining good health through diet and exercise.
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