Neutropenia
A low neutrophil count: grading by infection risk, Duffy-null associated neutrophil count, drug-induced agranulocytosis (carbimazole, clozapine, sulfasalazine, co-trimoxazole), post-viral, nutritional and autoimmune causes, LGL leukaemia and Felty syndrome, cyclic neutropenia, and when to biopsy the marrow.
Tier 1Approach to a presentation
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Neutropenia is an absolute neutrophil count (ANC) under 1.5 x 10^9/L in adults. The risk of bacterial and fungal infection depends on depth and duration, not the label.
- Decide three things first: how low, how long (compare old counts), and whether other lineages are down.
- The commonest causes in a well adult are drugs, recent viral infection and the Duffy-null associated neutrophil count.
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Sources
- How we evaluate and treat neutropenia in adultsGibson C, Berliner N. Blood 2014;124:1251-8, 2014
- Benign ethnic neutropeniaAtallah-Yunes SA, Ready A, Newburger PE. Blood Rev 2019;37:100586, 2019
- Cancer trial eligibility and therapy modifications for individuals with Duffy null-associated neutrophil countHibbs SP et al., JAMA Netw Open 2024;7:e2432475, 2024
- Consensus guidelines for antibacterial prophylaxis in patients with neutropeniaAU/NZLindsay J et al., Intern Med J 2025;55 Suppl 7:115-35 (2024 Australasian consensus guidelines), 2024 (published 2025)
- Antibiotic (Therapeutic Guidelines), febrile neutropenia topicAU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy