From the Research
Conditions Associated with Hypochromia, Neutropenia, and Lymphocytosis
- Hypochromia is often associated with iron deficiency anemia, but can also be seen in other conditions such as thalassemia and sideroblastic anemia.
- Neutropenia, defined as an absolute blood neutrophil count (ANC) <1.5 G L(-1), may accompany a variety of diseases, including: + Viral infections, such as HIV 1 + Haematological malignancies, such as acute leukaemias and myelodysplastic syndromes 1, 2 + Primary immunodeficiency syndromes, such as X-linked agammaglobulinemia (XLA) and common variable immunodeficiency (CVID) 3 + Monogenic disorders, such as congenital neutropenia and cyclic neutropenia 4
- Lymphocytosis, or an elevated lymphocyte count, can be seen in a variety of conditions, including: + Viral infections, such as infectious mononucleosis + Chronic idiopathic neutropenia, which can be associated with lymphocytosis and an increased risk of developing haematological malignancies 2 + Primary immunodeficiency syndromes, such as severe combined immunodeficiency (SCID) and Wiskott-Aldrich syndrome
Key Findings
- Neutropenia is an ominous sign that necessitates careful follow-up, as it can be associated with an increased risk of developing haematological malignancies and mortality 1
- Chronic idiopathic and autoimmune neutropenia, although usually benign, deserve haematological follow-up with a bone marrow evaluation at diagnosis and a re-evaluation in the presence of worsening neutropenia, appearance of additional cytopenias, and lymphocytosis 2
- The diagnosis and management of neutropenia can be challenging, but the introduction of next-generation sequencing is improving the accuracy and expediency of diagnosis and clinical management 4