Talk:Neutropenia/Archive 1

Merge agranulocytosis with neutropenia
I think agranulocytosis can be merged here as it is just a severe gradation of neutropenia. Neutropenia is usually defined as less than 1500 neutrophils / microliter and agranulocytosis less than 100 neutrophils / microliter, so I think it would be more clear if they were in one article even though they can have different causes. --WS 19:49, 16 August 2005 (UTC)


 * I'm not sure. They are not used interchangably. PTU & carbimazole, clozapine and antiepileptices are always said to cause agranulocytosis, not neutropenia. Perhaps Googling on the various terms will clarify the matter. Also, haematologists call N = 0.0 still neutropenia and not agranulocytosis. JFW | T@lk  22:04, 16 August 2005 (UTC)


 * Drug-induced agranulocytosis cannot happen before first going through neutropenia. --WS 18:06, 17 August 2005 (UTC)

I agree that they are not used interchangeably. While they may be the same in principle, they are used differently in different situations. However, a note should be made in each article that agranulocytosis is considered a form of neutropenia.


 * Don't you mean the other way round? Agranulocytosis implies that non-neutrophil granulocytes (eosinophils and basophils) are also affected. I would not be happy with every article containing more terminology. JFW | T@lk  17:31, 17 August 2005 (UTC)

Two definitions of agranulocytosis are being used. Strictly defined, it would mean low levels of all granulocytes. But most times, despite of its name, it seems to be used for a near-zero count of neutrophil granulocytes (not all granulocytes). In practice, when neutrophil granulocytes are low, the other granulocytes are are almost always low as well. --WS 18:01, 17 August 2005 (UTC)


 * Even in most medical text books I have looked up, agranulocytosis and neutropenia are used almost interchangeably. I think they would be best merged, with a mention of the difference between the two (practical the level of neutrophiles and theoretical about the difference in blood cells involved). Both are almost always caused by mechanisms (diseases or drugs) which inhibit the granulocyte precursors and thereby can cause neutropenia as well as agranulocytosis. --WS 18:16, 17 August 2005 (UTC)

Oh, and the term granulocytopenia exist as well, which would be less severe than agranulocytosis. It currently redirects to granulocyte. --WS 18:19, 17 August 2005 (UTC)

I'd suggest it's a good idea to keep agranulocytosis as a seperate article with a brief description of what it means, possible causes, and then a reference to neutropenia, explaining the interchangability of the terms (despite the technical difference). It is always far more confusing to have to dig through articles trying to find a quick description of the term you are searching for. But certianly, keep agranulocytosis brief and restrict information on it to that which is very specific to it (as opposed to other forms of neutropenia). 220.235.91.175 13:09, 3 November 2005 (UTC)

Agranulocytosis and neutropenia are technically not interchangeable terms. They shouldn't be merged. I agree with the above in keeping agranulocytosis as a brief separate article --203.122.202.71 22:38, 12 November 2005 (UTC)

I think it is good that it has its own article. it is much easier to look up. Maybe just a reference link at the top/bottom to the other article would suffice. Agranulocytosis and neutropenia however related they are different things agranulocytosis is as the name describes it, a lack of granulocytes in general including neutrophil, basophil, and eosinophils, whilst the term neutropenia describes a hemotological lack of only neutrophil granucolytes. This is why I feel that each should be included in each others articles like they already are, and not combined due to there large differences. Steven age 15 Canada.

Vote on Merger
I'm working on merging articles and it seems that there isn't much of a consenus on this one. Could those users who have been dicussing this vote on the merge down here? Just a simple show of metaphorical hands with Merge of Don't Merge. Thanks. Kerowyn 00:14, 7 January 2006 (UTC)


 * I'll abstain for now, but for what its worth, ICD seems to prefer Agranulocytosis, with Neutropenia listed as an subordinate term, so if we merge, we might want to merge the other direction. --Arcadian 01:13, 7 January 2006 (UTC)


 * I'm working in haematology at the moment and although, as mentioned in the discussion above, neutropenia and agranulocytosis may well sound similar, they are distinct entities. In many cases neutropenia is caused by reduced granulopoiesis - there are cases, however, where neutrophils are removed by the RES (reticuloendothelial system) or other tissues, leading to a strict neutropenia, with normal levels of other granulocytes.  They are distinct and should stay that way. drjermy 12:06, 31 January 2006 (UTC)

My mother is a myeloma patient and a nurse, and we agree with Drjermy on this one. She has been neutropenic without being agranulocytosic due to the cancer and various treatments for it. We see it is the same argument as, all oranges are fruit, but not all fruit are oranges. Neutropenia is a component of agranylocytosis, but agranulocytosis is not just neutropenia. Thanks for allowing disucssion on this. Kelelain

EDIT: I didn't read closely enough - I voted merge thinking this was still the discussion on merging febrile neutropenia into neutropenia. I haven't read up enough on the agranulocytosis merger proposal to have an informed opinion on it yet. I'll likely be back with my two cents ;)Spiral5800 (talk) 20:36, 7 February 2010 (UTC)

Don't Merge - Having taken a look and having read the comments, I have to agree that agranulocytosis and neutropenia are definitely different enough to warrant their own articles - one is not defined as a subtype of the other. This is in contrast with my merger proposal that febrile neutropenia be merged into neutropenia. No clear consensus - as in votes - seemed to appear there, but no clear objections arose either. If individuals could take another look at that proposal and vote, I would appreciate it. I'm tempted to simply perform the move after having read what comments people have given so far, but hesitate to make such a relatively major change without a clear consensus. Thanks! Spiral5800 (talk) 20:43, 7 February 2010 (UTC)


 * Decisions on Wikipedia are usually made by discussion, not voting, because Polls are evil. WhatamIdoing (talk) 03:44, 11 February 2010 (UTC)

Data falsification
I will remove claims that data was falsified unless reliable sources are cited that support this controversial claim. JFW | T@lk  22:52, 21 March 2007 (UTC)

This is not controversial. The authors themselves retracted the paper:

http://bloodjournal.hematologylibrary.org/cgi/content/full/103/2/389

Retraction of Aprikyan et al. Re: Aprikyan A, Carlsson G, Stein S, et al. Neutrophil Elastase Mutations in Severe Congenital Neutropenia Patients of the Original Kostmann Family. Blood First Edition Paper, prepublished online January 16, 2003; DOI 10.1182/blood-2002-04-1255. The authors respectfully withdraw this paper from final publication consideration. As noted in the journal's published Notice of Investigation, errors in some of the digital images in the manuscript are under investigation. Additional findings concerning patient data make some of the conclusions of our report uncertain. We therefore retract the prepublished paper and extend our deepest apologies to the scientific community.
 * RETRACTION

Andrew A. Aprikyan, Goran Carlsson, Steve Stein, Anush Oganesian, Bengt Fadeel, David C. Dale, Jan Palmblad, and Jan-Inge Henter (authors)

AND NOTE that the journal never concluded the investigation (at least nothing to that effect was published).

Moved for review
The following section was removed:


 * Severe chronic neutropenia may be present at birth (congenital neutropenia) or may occur at any stage in life (acquired neutropenia).
 * There are several types of severe chronic neutropenia:
 * Severe congenital neutropenia &mdash; a rare inherited form of the disease usually detected soon after birth. It affects children mainly and may result in premature loss of teeth and peremptory gum infections. The most severe form of chronic congenital neutropenia is known as Kostmann’s syndrome. It is genetically heterogeneous. Most commonly, it arises as a result of new, autosomal dominant mutations in the gene, ELA2, encoding the neutrophil granule protease, neutrophil elastase, NE. The gene responsible for many cases of autosomal recessively inherited severe congenital neutropenia is HAX1. The mechanism for congenital neutropenia is not well-understood. There is evidence that mutations in neutrophil elastase, or in other genes associated with syndromic forms of neutropenia, disrupt its intracellular trafficking. Apoptosis may be a final effector for neutropenia, but the original studies from Dale and Aprikian supporting this pathway were retracted.


 * Cyclic neutropenia &mdash; tends to occur every three weeks and lasting three to six days at a time due to changing rates of cell production by the bone marrow. It is often present among several members of the same family. Cyclic neutropenia is also the result of autosomal dominantly inherited mutations in ELA2, the gene encoding neutrophil elastase.


 * Idiopathic neutropenia &mdash; a rare form of neutropenia which develops in children and adults usually in response to an illness. It is diagnosed when the disorder cannot be attributed to any other diseases and often causes life-threatening infections.


 * Myelokathexis &mdash; a rare form of inherited autosomal dominant disease associated with severe neutropenia. Some but not all patients have warts, hypogammaglobulinemia, and recurrent infections. Therefore myelokathexis is also known as the W.H.I.M. syndrome. In spite of severe neutropenia (low number of neutrophils) in peripheral blood of myelokathexis patients, their bone marrow is hypercellular and it is packed with mature neutrophils indicating an impaired mobilization of hematopoietic cells in this disorder. Truncating mutations in the human cytokine receptor CXCR4 gene were identified in most of the families afflicted by myelokathexis. The molecular mechanism is not yet defined. Recent reports demonstrate that CXCR4 mutations appear to result in an increased sensitivity of bone marrow hematopoietic cells to its ligand, a stromal-derived growth factor SDF-1 that provides proliferative and survival signals.


 * Autoimmune neutropenia &mdash; most common in infants and young children where the body identifies the neutrophils as enemies and makes antibody to destroy them. This form usually lessens in severity within two years of diagnosis.


 * Chemotherapy Induced Neutropenia is a condition characterized by abnormally low blood levels of infection-fighting neutrophils, a specific kind of white blood cell. The most common reason that cancer patients experience neutropenia is as a side effect of chemotherapy. Chemotherapy involves the use of drugs to destroy cancer cells. Chemotherapy works by destroying cells that grow rapidly, a characteristic of cancer cells. Unfortunately, chemotherapy also affects normal cells that grow rapidly, such as blood cells in the bone marrow, cells in the hair follicles, or cells in the mouth and intestines. Chemotherapy-induced neutropenia typically occurs 3-7 days following administration of chemotherapy and continues for several days before neutrophil levels return to normal. The type and dose of chemotherapy affects how low the neutrophil count drops and how long it will take to recover.


 * Chemotherapy-induced neutropenia is important because it may: Increase a patients risk of life-threatening infection and or disrupt delivery of cancer treatment, resulting in a change to the planned dose and time. The fewer the neutrophils in the blood and the longer patientsremain without enough neutrophils, the more susceptible patients are to developing a bacterial or fungal infection. Neutrophils are a major component of antibacterial defense mechanisms. As the neutrophil count falls below 1.0, 0.5, and 0.1 x 109/L, the frequency of life-threatening infection rises steeply from 10% to 19% and 28%, respectively. If patients develop a fever during neutropenia they may require treatment with intravenous antibiotics and admission to the hospital until the number of neutrophils in the blood returns to sufficient levels to fight the infection.


 * Another reason neutropenia is important is that, in some cases, it can be severe enough that it can cause the chemotherapy treatment to be delayed or dose reduced, which reduces some patients’ chance for cure. When patients are treated with chemotherapy, it is for the purpose of destroying cancer cells in order to reduce symptoms from your cancer, prolong your survival or increase your chance of cure. The dose and time schedule of chemotherapy drugs administered have been scientifically determined to produce the best chance of survival or cure. If patients develop neutropenia, doctors may have to delay your treatment or reduce the doses of chemotherapy until the neutrophil counts have recovered. Clinical studies have shown that, for certain cancers, reducing the dose of chemotherapy or lengthening the time between treatments lowers cure rates compared to full-dose, on-time treatment. There are however strategies for the prevention of chemotherapy-induced neutropenia that have been proven to reduce the incidence of fever, infection, admission to the hospital and allow patients to receive treatment on schedule.


 * Who is at a higher risk for chemotherapy-induced neutropenia?
 * Patients receiving chemotherapy that decreases the number of white blood cells
 * Patients who already have a low white blood cell count, or who have previously received chemotherapy or radiation treatment
 * Patients age 70 and older who may be at risk of more severe infection and longer hospitalizations
 * Patients with other conditions affecting their immune system


 * Chemotherapy-induced neutropenia can be prevented in most patients with the use of white blood cell growth factors. Blood cell growth factors are naturally occurring substances called cytokines that regulate certain critical functions in the body. They are responsible for stimulating cells in the bone marrow to produce more blood cells. The white blood cell growth factors approved by the U.S. Food and Drug Administration for the prevention of chemotherapy-induced neutropenia are Neupogen® (filgrastim) and Neulasta® (pegfilgrastim).

Much of the new content was copyvioed. The old content, entirely unsourced, is a mixed bag of conditions that is best dealt with in an organised list with subarticles split off when necessary. JFW | T@lk  22:34, 17 February 2008 (UTC)


 * I have to agree that this content reads more like a laundry list than encyclopedic material, but have one concern: was this stuff tagged for at least a few months before it was removed, so that editors would have a chance to improve it before it was removed outright? For obvious reasons that would be preferable.  If not, was there a very clear copyright issue warranting this content's immediate removal?  Spiral5800 (talk) 20:46, 7 February 2010 (UTC)


 * In light of my previous comment, I would also like to encourage editors to try and get any of this material that is potentially article-worthy back into the article, with the appropriate references, etc. of course. This is indeed a laundry list of conditions, but the fact that as it existed (and is printed here) is/was like a laundry list doesn't mean that the conditions listed aren't real and aren't worthy of being covered (properly) on wikipedia.  Spiral5800 (talk) 20:49, 7 February 2010 (UTC)

Cancer
Do any non-hematologic neoplasms (e.g., breast cancer) actually cause neutropenia themselves (that is, not the side effects of treatment)? Shouldn't this line be replaced with hematological malignancies? WhatamIdoing (talk) 17:46, 29 August 2008 (UTC)


 * I am not personally familiar with any non-hematologic cancers that on their own cause neutropenia. In the case of cancer, I'm only familiar with hematological neoplasms and chemotherapy for non-hematologic neoplasms causing neutropenia.  I may be wrong, of course.  Have you done any further study (perhaps outside wikipedia - i know, it's hubris, but sometimes we must go to extremes) to investigate your question? Spiral5800 (talk) 20:54, 7 February 2010 (UTC)

Causes
This was added:


 * infections like tuberculosis, typhoid, brucellosis, malaria, leishmaniasis, many viral infections

specifically as a cause of decreased production by the bone marrow. This seems rather unlikely to me (although increased destruction feels plausible), but does anyone have a proper reliable source that addresses the mechanism by which neutropenia appears in some infectious diseases? WhatamIdoing (talk) 21:35, 8 October 2009 (UTC)


 * This article lists some infectious diseases (like Epstein-Barr) being causes of neutropenia, but does not get into the mechanism which appears to be the focus of your question? Spiral5800 (talk)


 * Here is a page which seems to address your question a bit more directly. It appears to be a reliable source.  Let me know what you think! Spiral5800 (talk) 20:59, 7 February 2010 (UTC)


 * Most editors who work regularly in medicine-related articles reject WrongDiagnosis.com as a reliable source. WhatamIdoing (talk) 04:40, 8 February 2010 (UTC)


 * I've read that tuberculosis bacteria can hide out in bone marrow, this has been discussed in academic literature quite extensively. I'm wondering if this may be the cause of the destruction of bands/neuts. But I would think at the very least, this would cause destruction of the myeloid lines generally, and not be neutrophil specific? I don't know about the other listed conditions. I'm a medical sociologist/patient, so may even be incorrect here. Shelly Pixie (talk) 16:45, 3 November 2013 (UTC)

I was wondering if there should be any reference to benign ethnic neutropenia in the Causes section. 10/15/2014 — Preceding unsigned comment added by 198.175.154.212 (talk) 21:32, 15 October 2014 (UTC)

Merger proposal
The article on febrile neutropenia seems to lack enough original content to be a separate article; that is, it seems the information would be far better placed in context in this article. I originally thought that the febrile neutropenia article should simply be expanded; it lacks a great deal of important information on causes, outcomes, and treatments. After some consideration, though, I began to think that merging was more appropriate. I will post here what I originally posted there. Spiral5800 (talk) 12:43, 25 January 2010 (UTC)
 * Merge is obviously my vote, and the following is, at least partly, why.

This is what I originally said when I was still thinking that expanding the article on febrile neutropenia was the answer.
 * "I added the expand template to this article for several reasons. First, it doesn't have any sections - it's really only a stub. In actuality, this article could reasonably be expected to have numerous sections detailing causes, complications, the prognosis in various cases, and treatment modalities. This article could even have a Popular Culture section - in an episode of "The L Word" a major character dies from febrile neutropenia while undergoing chemotherapy for breast cancer. Although treatment is mentioned some, nowhere in the article is the use of immune-boosting drugs discussed. I know from many other sources that in cases of febrile neutropenia that are severe enough, protein drugs that either hasten the maturation of immune cells or that stimulate the immune system to produce more white blood cells are administered in order to help relieve the neutropenia and, in so doing, help the body fight off any infection. I would have added this to the article myself if I remembered a single source where I read this, but having noticed that so many other things were missing from this article, I thought I would go this route instead. Also unmentioned are other causes of febrile neutropenia (that is, causes other than chemotherapy.) For example, immunosuppressed individuals suffering from AIDS can develop this condition, as can transplant organ recipients who are on immunosuppressing drugs - or anybody who, for one reason or another, is taking a drug that suppresses the immune system. I imagine that the article on neutropenia may have more of this information available, and that info from that article can be added to this one. I hope that it does. If that is the case, in its current form this article might be better off merged into the neutropenia article, as it offers so little information."

Now, I still believe that febrile neutropenia COULD reasonably have its own article if said article was significantly expanded, but if that were to happen, the articles on febrile neutropenia and neutropenia would appear extremely similar, because as is apparant from the names, the major difference between the two is simply the presence of a fever. What do you all think? Thanks a great deal for all input. Spiral5800 (talk) 12:55, 25 January 2010 (UTC)


 * I propose that febrile neutropenia be moved to neutropenic sepsis,a condition more distinct than febrile neutropenia.I also support this move as it is reasonable to say that most febrile patients who are also neutropenic have bacteremia and sepsis.So,if wikipedia does not already have a page on neutropenic sepsis,i will move febrile neutropenia to neutropenic sepsis.Immunize (talk) 16:08, 25 January 2010 (UTC)
 * I checked to see weather or not there was a page on neutropenic sepsis,and I discovered that neutropenic sepsis redirects to febrile neutropenia.Does this preclude a move to neutropenic sepsis? Immunize (talk) 16:13, 25 January 2010 (UTC)


 * We can move the page over the redirect, if desired.
 * It's not clear to me what the best target for a merge is. Neutropenia can be afebrile; fevers are not always associated with neutropenia; febrile neutropenia doesn't always mean bacteremia and sepsis.  Consequently, I don't really favor the merge, because there isn't a single obvious page to merge it to.  WhatamIdoing (talk) 19:08, 25 January 2010 (UTC)

This is all a misunderstanding. Neutropenia in itself can have numerous causes, and deserves an independent treatment that should be kept separate from its main complication, "febrile neutropenia" or "neutropenic sepsis". Those terms are used interchangeably but the former is more popular in the USA and the latter in the UK. This is a particular acute clinical conundrum that should definitely have its own article and I would vote against any sort of merger. JFW | T@lk  21:15, 25 January 2010 (UTC)
 * I would just like to point out that the article in question has been moved, and this resulted in a few double redirects that need to be taken care of when this issue is settled. PDCook (talk) 21:32, 25 January 2010 (UTC)
 * A bot fixed them...that was fast. PDCook (talk) 00:28, 26 January 2010 (UTC)
 * So now this discussion also involves whether or not neutropenic sepsis should also be moved into the article neutropenia. I think I support this as well.  Merging these various subtypes of neutropenia into a single article on neutropenia seems to make a lot of sense, with redirects in place (for example, redirecting searches on febrile neutropenia to neutropenia#febrile_neutropenia).  Spiral5800 (talk) 23:41, 29 January 2010 (UTC)
 * Neutropenic sepsis isn't a type of neutropenia. It's an infection while you have a particular kind of immunosupression.  You can have sepsis without neutropenia, and neutropenia without sepsis (or without any sort of complications or infections at all).  WhatamIdoing (talk) 00:14, 30 January 2010 (UTC)

I have just moved "septic neutropenia" back to the much more current term of "febrile neutropenia". As I pointed out, this is a specific scenario where a patient with neutropenia develops a temperature. The reduced immune function puts the patient at risk of severe and potentially life-threatening complications. The term "sepsis" is technically correct (fever + neutropenia automatically meets the criteria for SIRS), but a large proportion of patients never develop other symptoms if treated well. Can I state again that I strongly oppose a merge? FN is a very specific scenario and should be kept separate from a discussion about the causes of neutropenia. JFW | T@lk  11:32, 31 January 2010 (UTC)
 * I'm closing this as "no support for the merge"; consensus can change in the future, but there is no support at this time. My main motivation in formally closing this is to focus attention on the other proposed merge.  WhatamIdoing (talk) 20:27, 13 February 2010 (UTC)

Chemo Merger Proposal
For very similar reasons - really the exact same reasons - as I suggested febrile neutropenia be merged into this article, I've made the same suggestion for the article chemotherapy-induced neutropenia. This is another example of a type of neutropenia that has its own article when, really, it seems that wikipedia would be better served by having those sub-articles merged into this main article. Again, much of my reasoning can be found lower down on this page (Here: Talk:Neutropenia) where I propose febrile neutropenia being merged into this article as well. Do people agree or disagree? Thanks. Spiral5800 (talk) 21:14, 7 February 2010 (UTC)


 * I support this merge. WhatamIdoing (talk) 04:40, 8 February 2010 (UTC)


 * Also, please see on this page; it appears that the chemo-specific page is an impermissible WP:Content fork.  WhatamIdoing (talk) 20:27, 13 February 2010 (UTC)


 * I support aswell. Doc James (talk · contribs · email) 22:32, 27 May 2010 (UTC)


 * I've redirected it. The only thing on the page that isn't in the section above at  is a source:
 * Perhaps someone else would look over the content on the page, and the content above at, and see whether there's anything that really needs to be salvaged? (Nothing particularly stood out to me, but I didn't look closely.) WhatamIdoing (talk) 23:29, 27 May 2010 (UTC)
 * Perhaps someone else would look over the content on the page, and the content above at, and see whether there's anything that really needs to be salvaged? (Nothing particularly stood out to me, but I didn't look closely.) WhatamIdoing (talk) 23:29, 27 May 2010 (UTC)

History
The following was added:

''Neutropenia was first described by the Cuban Medical Doctor Antonio Béguez César in 1942, and published in the Cuban Pediatric Society bulletin in 1943. He named it "Neutropenia Crónica atipica familiar con granulaciones de los leucocitos". Neutropenia is also known as Béguez-César syndrome or disease. Dr. Beguez Cesar was the first complete work about immunodeficiency in the history of medicine''

This needs a secondary source, and it is conflict with the current version of the history. JFW &#124; T@lk #


 * A quick search reveals that he is mainly credited for work on Chédiak–Higashi syndrome. JFW &#124; T@lk  23:21, 27 November 2010 (UTC)

confusion
You say: "As of 2011, the Neutropenic Diet Guideline includes the following recommendations[6]: Avoid raw vegetables and fruit. (...) No well water No yogurt"

No vegetables, no water and no yogurt. Shocking. Really. I was searching google for low white cell blood count and how to boost it and found that almost every website recommended veggies, water and yogurt. Examples below.

"Give your child's immune system a boost by including lots of yogurt that contains live active cultures of Lactobacillus Bulgaricus and Strepococcus thermophilus." source - http://www.ivillage.com/low-white-blood-count-diet/

In article "Boost Low White Blood Cell Count and Immune Function Naturally" (source www.naturalnews.com/028275_white_blood_cells_immune_function.html #ixzz1sUVnVLoe) is the following: "Drink plenty of water to boost the immune system as well as flush out toxins" and "Yogurt can be very beneficial for the immune system."

Actually your article is the only one that is against yogurt for improving the immune system/low white blood cell count. Somebody got it wrong, either you (your source) or the other websites. — Preceding unsigned comment added by Goonero (talk • contribs) 13:12, 19 April 2012 (UTC)


 * ivillage.com and naturalnews.com are not reliable sources. They're both content-mill fluff.  If someone has a severely compromised immune system, no, they should not eat raw produce, as they may not have the ability to fight off any naturally occurring or acquired-in-harvest-and-transport bacteria.  They should cook everything they eat at a temperature high enough to kill those organisms.


 * Same with yogurt--live cultures (bacteria) are great to boost a normal immune system, but could be dangerous to someone with a severe problem. — Preceding unsigned comment added by 184.38.96.49 (talk) 22:20, 13 September 2012 (UTC)


 * I second the above regarding the ivillage articles et al., being incorrect where neutropaenia is concerned. Neutropaenia is a condition where the body either cannot make enough white cells, or where the white cells are dying off very quickly. Introducing bacteria from yoghurt, bacteria from water from wells and fountains, or bacteria from raw foods can overwhelm what meagre immune system a neutropaenic patient may have. It can be life-threatening in some cases. This is not simply someone being a bit run-down but within normal ranges of immune function; this is, for many, a serious chronic medical condition where adding in extra bacteria (from say, a live yoghurt) will result in their white cells being totally overwhelmed, a hospitalisation required, with reverse barrier care and intra-venous antibiotics. Shelly Pixie (talk) 01:41, 1 September 2013 (UTC)

Amifostine
The language may be overreaching. Some data showed a potential for cytoprotection i.e. a lessening (a modest effect, not a complete ablation of the decrement, of using amifostine preventatively) of neutropenia (a number); whether this meaningfully reduces RISK of infection (preventing a clinical outcome of that low number) is less clear, and the claim here that it is used in infection (implied ESTABLISHED) is DUBIOUS. Any input before I correct this? FeatherPluma (talk) 00:58, 23 June 2014 (UTC)

Practical review
10.1182/blood-2014-02-482612 from Blood JFW &#124; T@lk  21:30, 23 August 2014 (UTC)

Chronic neutropenia
10.1111/bjh.13798 - myelopoeisis and neutrophil apoptosis. JFW &#124; T@lk  08:19, 14 October 2015 (UTC)

Looks great
I'm ready for some collaboration. Do you have a job for me or should I just get to work?
 *  Bfpage &#124;leave a message 21:26, 11 December 2015 (UTC)

Chronic Idiopathic Neutropenia and other types of neutropenia
I do believe the article should include a breakdown of the types of neutropenia such as Chronic Idiopathic Neutropenia, Autoimmune Neutropenia, etc. The article briefly delves into some of the types of neutropenia but omits some. Also, it is NOT know if Chronic Idiopathic Neutropenia is autoimmune. The jury is still out on that one. Autoimmune neutropenia is a separate entity of Chronic Idiopathic Neutropenia too. 71.177.61.36 (talk) 03:01, 24 January 2016 (UTC)
 * I'm uncertain if that would be of worth in a general article for lay persons. After all, hyperthyroidism also can have neutropenia (and other lack of blood cells), which would be better addressed in articles on hyperthyroidism. As the condition isn't highly common, with certain subsets of hyperthyroid suffering individuals experiencing that, it'd needlessly lengthen an article. Full disclosure, I'm one of that subset and consider it needless, to avoid an unnecessarily lengthy article, when it could be better addressed on hyperthyroidism articles. Any experts in the house? We might turn this one into a GA.Wzrd1 (talk) 04:00, 26 February 2016 (UTC)

Query
"May be can not be relied upon" doesn't make sense to me. Any suggestions?  Ϣere Spiel  Chequers  21:29, 7 June 2016 (UTC)

Query
"May be can not be relied upon" doesn't make sense to me. Any suggestions?  Ϣere Spiel  Chequers  21:29, 7 June 2016 (UTC)
 * have trimmed--Ozzie10aaaa (talk) 13:09, 1 April 2020 (UTC)
 * Thanks Ozzie.  Ϣere Spiel  Chequers  22:35, 1 April 2020 (UTC)
 * WSC, what it meant was that these tests may give false negatives in the presence of neutropenia. I wouldn't be at all surprised if it's true (chest X-rays "see" inflammation, not specifically microbes), but I didn't happen to find that claim in a very brief search of the cited source.  WhatamIdoing (talk) 22:41, 1 April 2020 (UTC)
 * Yes, "Maybe can not be relied upon" was obviously one of the possibilities, but I'm not convinced that my advanced PhD in hypochondria truly qualifies me to make such calls in medical articles.  Ϣere  Spiel  Chequers  23:12, 1 April 2020 (UTC)