2. DEFINITION
• Leukopenia is an abnormal reduction of circulating white blood
cells, especially the granulocytes. The term leukopenia is often
used interchangeably with neutropenia.
• It may result from reduced production of white blood cells or
increased utilization and destruction, or both.
3. NORMAL WBC COUNTS
• For normal adult the WBC counts range between 4500 and 11000 per
cubic millimeter of blood.
• This is slightly higher in children.
5. TYPES OF WHITE BLOOD CELLS
• There are five types of white blood cells. Each helps to protect the
body from a different kind of infection:
• Neutrophils: These make up 55 to 70% of total white blood cells.
They help fight off fungal and bacterial infections.
• Lymphocytes: These are the second most common type of white
blood cell. They protect the body from viral infections.
6. TYPES OF WHITE BLOOD CELLS
• Basophils: These are the least common type of the white blood cells.
They are involved in inflammatory reactions to allergens.
• Monocytes: These are the largest of the white blood cells. They play a
role in fighting off bacteria, fungi, and viruses. They also help mend
tissue that has been damaged by inflammation
• Eosinophils: These fight parasites and play a role in allergic reactions
and conditions, such as Asthma
7. CAUSES AND RISK FACTORS
• APLASTIC ANEMIA – A condition where the bone marrow doesn’t produce new blood cells
• CANCER OR DISEASES OF THE BONE MARROW – Such as Multiple Myeloma,
Leukemia
• CERTAIN MEDICATIONS – Medicines that destroy white blood cells are bupropion ,
clozapine , cyclosporine
• CANCER TREATMENTS – Including Chemotherapy, Radiation therapy and bone marrow
transplant
• CONGENITAL CONDITIONS – Kostmann’s syndrome is a congenital disorder of the bone
marrow
8. CAUSES AND RISK FACTORS
• INFECTIOUS DISEASES – Such as HIV/AIDS, Tuberculosis
• HYPERSPLENISM – When the spleen destroys white blood cells
• SEVERE INFECTION – An infection that uses white blood cells to fight
infection faster than the body can produce them
• AUTOIMMUNE DISORDERS: Some of these kill white blood cells.
Examples include Lupus and Rheumatoid Arthritis
• SARCOIDOSIS: A collection of inflammatory cells in the body .This is an
overreaction of the immune system. It can also affect bone marrow.
9. SYMPTOMS OF LEUKOPENIA
• No definite symptoms until pt becomes infected
• Fever 100.5˚F (38˚c)
• Chills
• Sweating
10. DIAGNOSIS
• History
• CBC with differential count
• Blood Culture
• Other investigations to find the cause
11. TREATMENT
Vary depending on what is causing leukopenia. Treatments include:
• DISCONTINUING TREATMENT THAT CAUSES LOW WHITE BLOOD
CELL COUNTS – Can include medications, Chemotherapy or Radiation (Reduce
the dose)
• GROWTH FACTOR THERAPY – (G-CSF) Granulocyte Colony Stimulating
Factor. It increases the neutrophil production in bone marrow
• LOW-BACTERIAL DIET – A diet that minimizes exposure to bacteria -- such as
raw, unwashed products or undercooked meat
• MEDICATIONS – Antibiotics that fights the infection
12. DEFINITION
• Agranulocytosis, also known as agranulosis or granulopenia,
is an acute condition involving a severe and dangerous
leukopenia (lowered white blood cell count), most
commonly of neutrophils causing a neutropenia in the
circulating blood.
13. ETIOLOGY
• The exact cause is unknown
• It may be because of either
1. Decreased production of neutrophils or
2. Increased destruction of neutrophils
DECREASED PRODUCTION OF NEUTROPHILS
• Aplastic anemia
• Cancers, lymphoma and leukemia
• Chemotherapy
• Radiation therapy
14. ETIOLOGY
INCREASED DESTRUCTION OF NEUTROPHILS
• Hypersplenism
• Auto Immune Disorders
• Bacterial or Viral Infections
• Use of Drugs- Psychotropic Medicines, Anti Thyroid Agents, Anti
Coagulants And Antibiotics
15. CLINICAL FEATURES
EARLY SYMPTOMS ARE
• Sudden Fever
• Chills
• Sore Throat
• Weakness
• Sore Mouth And Gums
• Mouth Ulcers
• Bleeding Gums
LATE SYMPTOMS
•Tachycardia
• Tachypnea
• Low Blood Pressure
• Skin Abscesses
16. DIAGNOSIS
• • HISTORY COLLECTION AND PHYSICAL EXAMINATION
• • BLOOD STUDIES
• Complete Blood Count ---Neutrophil Count will be below 500, and
can reach 0 cells/mm³
• • CULTURE STUDIES
• Culture of Urine, Blood And Ulcerative Lesion in throat are
positive for bacteria
17. MANAGEMENT
1. COLONY STIMULATING FACTORS:
Effective in increasing neutrophil production.
2. ANTIBIOTICS/ANTIVIRAL
Combination of broad spectrum antibiotics are usually administered
incase of viral and bacterial infections.
3. CORTICOSTEROIDS
Corticosteroids may be used if the cause is an immunological
disorder
18. NURSING MANAGEMENT
NURSING DIAGNOSIS
• • Risk for infection related to neutropenia
• • Knowledge deficit related to toxic agents that causes
agranulocytosis
19. NURSING MANAGEMENT
NURSING DIAGNOSIS
• Risk for infection secondary to impaired immunocompetence R/T
decreased WBC
NURSING INTERVENTIONS
• Through hand washing by everyone who enters pt’s room
• Allow no one with cold or sore throat to care for pt
• Care for neutropenic patient before caring other pt as much as possible
• Ensure room is cleaned daily
20. NURSING MANAGEMENT
• Change Water in containers -- O2 humidifiers
• Provide low microbial diet
• Eliminate fresh salads and unpeeled fresh fruits
• Provide total body hygiene daily
• Administer antimicrobials on time
• Maintain meticulous IV site care
21. NURSING MANAGEMENT
• • Monitor patients leukocyte count regularly
• • Maintain strict aseptic techniques during procedures
• • Maintain proper isolation of the patient
• • Administer proper antibiotics to the patient
• • Provide skin care and prevent dryness of the skin
• • Provide psychological support to the patients
• • Encourage to avoid self medications
22.
23. • Kostmann syndrome is a rare, severe, congenital
neutropenia disorder characterized by a lack of mature neutrophils (absolute
neutrophil counts less than 500 cells/mm3) associated with frequent, recurrent
bacterial infections (e.g. otitis media, pneumonia, sinusitis, urinary tract infections,
abscesses of skin and/or ...
• Growth factor therapy is a type of regenerative medicine that uses the body’s own
growth factors to promote the healing of wounds, chronic pain, degenerative
diseases such as arthritis, and other conditions. Growth factors are substances
produced in the body that stimulate the growth and proliferation of cells involved
with inflammation and healing, which aid in the body’s natural ability to repair
itself.
