eMedicine Specialties > Hematology > Immune System and Disorders
Granulocytopenia: Multimedia
Updated: Apr 8, 2009
Multimedia
 | Media file 1: Bilateral interstitial infiltrates in a 31-year-old patient with influenza pneumonia. |
 | Media file 2: Anteroposterior chest radiograph in a young ED patient presenting with cough and malaise. The radiograph shows a classic posterior segment right upper lobe density consistent with active tuberculosis. This woman was admitted to isolation and started empirically on a 4-drug regimen in the ED. Tuberculosis was confirmed on sputum testing. Image courtesy of Remote Medicine, remotemedicine.org. |
 | Media file 3: Lateral chest radiograph in the same patient as in Media file 1. Image courtesy of Remote Medicine, remotemedicine.org. |
 | Media file 4: Rapid test to distinguish hematuria from hemoglobinuria. The onset of red urine during or shortly after a blood transfusion may represent hemoglobinuria (indicating an acute hemolytic reaction) or hematuria (indicating bleeding in the lower urinary tract). If freshly collected urine from a patient with hematuria is centrifuged, red blood cells settle at the bottom of the tube, leaving a clear yellow urine supernatant. If the red color is due to hemoglobinuria, the urine sample remains clear red after centrifugation. |
 | Media file 5: Microcytic anemia. |
 | Media file 6: Examination of the peripheral smears in immune thrombocytopenic purpura often shows giant platelets. These platelets reflect the increased megakaryocytic mass in the marrow. |
 | Media file 7: The margins of this massive spleen were palpated easily preoperatively. Medially, the 3.18-kg (7-lb) spleen crosses the midline. Inferiorly, it extends into the pelvis. |
 | Media file 8: Doppler sonogram at the splenic hilum reveals hepatofugal venous flow in a patient with portal hypertension. |
More on Granulocytopenia |
| Overview: Granulocytopenia |
| Differential Diagnoses & Workup: Granulocytopenia |
| Treatment & Medication: Granulocytopenia |
| Follow-up: Granulocytopenia |
 Multimedia: Granulocytopenia |
| References |
| Further Reading |
| « Previous Page |
References
Beutler E, Lichtman MA, Coller BS, Kipps TJ, eds. Williams Hematology. 5th ed. New York, NY: McGraw-Hill; 1995:815-24, 844-58.
Lee GR, Foerster J, Lukens J, et al, eds. Wintrobe's Hematology. 10th ed. Baltimore, Md: William and Wilkins; 1999:1836-88.
Curnutte J, Coates T. Disorder of phagocyte function and number. In: Hoffman R, Benz EJ Jr, Shattil SJ, et al, eds. Hematology: Basic Principles and Practice. 3rd ed. New York, NY: Churchill Livingstone; 2000:720-62.
Boxer LA. Immune neutropenias. Clinical and biological implications. Am J Pediatr Hematol Oncol. Spring 1981;3(1):89-96. [Medline].
Welte K, Dale D. Pathophysiology and treatment of severe chronic neutropenia. Ann Hematol. Apr 1996;72(4):158-65. [Medline].
Young NS. Agranulocytosis. JAMA. Mar 23-30 1994;271(12):935-8. [Medline].
Grann VR, Bowman N, Joseph C, et al. Neutropenia in 6 ethnic groups from the Caribbean and the U.S. Cancer. Aug 15 2008;113(4):854-60. [Medline].
Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP. Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. Ann Intern Med. Apr 3 2007;146(7):486-92. [Medline]. [Full Text].
Bodey GP. Managing infections in the immunocompromised patient. Clin Infect Dis. Apr 1 2005;40 suppl 4:S239. [Medline]. [Full Text].
Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. Mar 15 2002;34(6):730-51. [Medline]. [Full Text].
National Comprehensive Cancer Network. NCCN practice guidelines for fever and neutropenia. Oncology (Williston Park). May 1999;13(5A):197-257. [Medline].
Schimpff SC. Empiric antibiotic therapy for granulocytopenic cancer patients. Am J Med. May 30 1986;80(5C):13-20. [Medline].
Kern WV, Cometta A, De Bock R, et al, for The International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer. Oral versus intravenous empirical antimicrobial therapy for fever in patients with granulocytopenia who are receiving cancer chemotherapy. N Engl J Med. Jul 29 1999;341(5):312-8. [Medline]. [Full Text].
Bow EJ, Mandell LA, Louie TJ, et al. Quinolone-based antibacterial chemoprophylaxis in neutropenic patients: effect of augmented gram-positive activity on infectious morbidity. National Cancer Institute of Canada Clinical Trials Group. Ann Intern Med. Aug 1 1996;125(3):183-90. [Medline]. [Full Text].
Hughes WT, Armstrong D, Bodey GP, et al, for the Infectious Diseases Society of America. 1997 guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. Clin Infect Dis. Sep 1997;25(3):551-73. [Medline].
Finberg RW, Talcott JA. Fever and neutropenia--how to use a new treatment strategy. N Engl J Med. Jul 29 1999;341(5):362-3. [Medline].
Freifeld A, Marchigiani D, Walsh T, et al. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy. N Engl J Med. Jul 29 1999;341(5):305-11. [Medline]. [Full Text].
Alanis A, Rehm S, Weinstein AJ. Comparative efficacy and toxicity of moxalactam and the combination of nafcillin and tobramycin in febrile granulocytopenic patients. Cleve Clin Q. Winter 1983;50(4):385-95. [Medline].
American Society of Clinical Oncology. Recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. J Clin Oncol. Nov 1994;12(11):2471-508. [Medline]. [Full Text].
American Society of Clinical Oncology. Update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based clinical practice guidelines. J Clin Oncol. Jun 1996;14(6):1957-60. [Medline].
Bain BJ, Phillips D, Thomson K, Richardson D, Gabriel I. Investigation of the effect of marathon running on leucocyte counts of subjects of different ethnic origins: relevance to the aetiology of ethnic neutropenia. Br J Haematol. Mar 2000;108(3):483-7. [Medline]. [Full Text].
Bass DA. Eosinophil behavior during host defense reactions. In: Gallin JI, Fauci AS, eds. Advances in Host Defense. New York, NY: Raven Press; 1982:211-42.
Bass DA, Gonwa TA, Szejda P, et al. Eosinopenia of acute infection: Production of eosinopenia by chemotactic factors of acute inflammation. J Clin Invest. Jun 1980;65(6):1265-71. [Medline]. [Full Text].
Bow EJ. Management of the febrile neutropenic cancer patient: lessons from 40 years of study. Clin Microbiol Infect. Oct 2005;11 suppl 5:24-9. [Medline].
Elting LS, Rubenstein EB, Rolston KV, Bodey GP. Outcomes of bacteremia in patients with cancer and neutropenia: observations from two decades of epidemiological and clinical trials. Clin Infect Dis. Aug 1997;25(2):247-59. [Medline].
Gurwith M, Brunton JL, Lank B, et al. Granulocytopenia in hospitalized patients. II. A prospective comparison of two antibiotic regimens in the empiric therapy of febrile patients. Am J Med. Jan 1978;64(1):127-32. [Medline].
Maher DW, Lieschke GJ, Green M, et al. Filgrastim in patients with chemotherapy-induced febrile neutropenia. A double-blind, placebo-controlled trial. Ann Intern Med. Oct 1 1994;121(7):492-501. [Medline]. [Full Text].
Pizzo PA, Hathorn JW, Hiemenz J, et al. A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. N Engl J Med. Aug 28 1986;315(9):552-8. [Medline].
Shoenfeld Y, Ben-Tal O, Berliner S, Pinkhas J. The outcome of bacterial infection in subjects with benign familial leukopenia (BFL). Biomed Pharmacother. 1985;39(1):23-6. [Medline].
Wright DG, Kenney RF, Oette DH, et al. Contrasting effects of recombinant human granulocyte-macrophage colony-stimulating factor (CSF) and granulocyte CSF treatment on the cycling of blood elements in childhood-onset cyclic neutropenia. Blood. Aug 15 1994;84(4):1257-67. [Medline]. [Full Text].
[Best Evidence] Massey E, Paulus U, Doree C, Stanworth S. Granulocyte transfusions for preventing infections in patients with neutropenia or neutrophil dysfunction. Cochrane Database Syst Rev. Jan 21 2009;CD005341. [Medline]. [Full Text].
Further Reading
Related eMedicine Topics
Best Evidence
- Massey E, Paulus U, Doree C, Stanworth S. Granulocyte transfusions for preventing infections in patients with neutropenia or neutrophil dysfunction. Cochrane Database Syst Rev. Jan 21 2009;CD005341. [Medline]. [Full Text].
Clinical Trials
- FDG-PET/CT In the Evaluation of Persistent Febrile Neutropenia in Cancer Patients
- Fatigue and Symptom Burden in Febrile Neutropenia
- A Pilot Study to Evaluate the Safety and Activities of EW02 in Reducing Neutropenia Caused by Chemotherapy
- Safety and Effectiveness of Granulocyte Transfusions in Resolving Infection in People With Neutropenia (The RING Study)
National Guidelines Clearinghouse
- 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. American Society of Clinical Oncology - Medical Specialty Society. 1994 Nov (revised 2006 Jul 1). 19 pages. NGC:005040
- Clinical guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation. American Academy of Pediatric Dentistry - Professional Association. 2004. 6 pages. [NGC Update Pending] NGC:004039
Keywords
granulocytopenia, neutropenia, agranulocytosis, granulopenia, leukopenia, hypogranulocytosis, neutrophils, eosinophils, basophils, granulocytes, granulocyte colony-stimulating factor, GCSF, granulocyte-macrophage colony-stimulating factor, GM-CSF
