Neutropenia involves a low neutrophil count, and thrombocytopenia involves a low platelet count. Certain conditions, infections, or medications may cause reduced levels of both.
Neutropenia and thrombocytopenia are two blood conditions that sometimes occur together.
Neutropenia is when you don’t have enough neutrophils. Neutrophils are white blood cells that repair wounds and destroy pathogens.
Thrombocytopenia is when you don’t have enough thrombocytes or platelets. Platelets play an important role in helping blood clot. Blood needs to clot to stop bleeding when you have a wound.
Neutropenia and thrombocytopenia may be more likely to occur in people with certain health conditions, such as autoimmune diseases and blood cancers. Keep reading to learn more about common causes.
The bone marrow synthesizes blood cells, including neutrophils and platelets. As they mature, they enter the bloodstream and circulate.
Sometimes, neutropenia and thrombocytopenia occur because of a condition that affects the bone marrow’s ability to produce enough blood cells. In other cases, health factors such as infection or medication reduce the amount of neutrophils and platelets in circulation.
Finally, autoimmune disorders can cause the immune system to make antibodies that attack and destroy certain blood cells.
The chart below lists some of the most common causes of neutropenia and thrombocytopenia.
| Type of condition | Examples |
|---|---|
| autoimmune diseases | If you have an autoimmune disorder such as rheumatoid arthritis or systemic lupus erythematosus, your body might make antibodies that kill certain types of blood cells. |
| cancers and cancer treatments | Leukemia and Hodgkin’s lymphoma are two types of cancer that affect your body’s ability to produce blood cells. Treatments like chemotherapy and radiation can destroy stem cells that could develop into neutrophils or platelets. |
| infections | Bacterial and viral infections can deplete your body’s stores of neutrophils and platelets. Some common infections include hepatitis C, HIV, and sepsis, among others. |
| medications | Antibiotics, antipsychotics, and drugs that treat cardiovascular diseases and epilepsy are a few types of medication linked to neutropenia and thrombocytopenia. |
Symptoms of neutropenia and thrombocytopenia can range from mild to severe. If your neutrophil and platelet levels are very low, you might be more likely to experience symptoms.
People with neutropenia tend to be more likely to get infections, such as pneumonia, ear infections, gingivitis, and sinus infections. They might experience common symptoms of infection, such as a fever, fatigue, and swollen lymph nodes, or find that cuts or wounds take a long time to heal.
Thrombocytopenia can also leave you feeling tired, but its symptoms are more specific. You may bruise more easily or bleed a lot if you don’t have enough platelets. People with thrombocytopenia can have frequent nosebleeds or heavy menstrual periods and may notice blood in their stool or urine.
It’s possible to have neutropenia and thrombocytopenia with anemia (low red blood cells). This condition is called pancytopenia.
If you have pancytopenia, all your blood cell counts are too low. Severe pancytopenia can sometimes lead to serious complications, including seizures and heavy bleeding.
How common is neutropenia with thrombocytopenia?
It’s hard to pinpoint exactly how many people have neutropenia with thrombocytopenia.
Neutrophil and thrombocyte levels can vary according to your age, sex, and ethnicity. Both conditions have many potential causes, which might mean that certain groups of people may experience them more often.
Also, they don’t always cause symptoms and may be underdiagnosed. They can resolve without treatment. In other words, you can have them without knowing it.
A healthcare professional may ask you about your symptoms and medical history, including medications you take and other conditions you have.
During a physical examination, they usually look for signs of neutropenia and thrombocytopenia, such as purpura, bruising, or swollen lymph nodes.
They may also order a complete blood count to measure your blood cell levels, including platelet and neutrophil levels, and a blood smear to look for blood cell irregularities.
If you have low neutrophils and platelets, a healthcare professional may suggest additional tests to determine the cause.
A doctor can identify treatments that target the root cause of neutropenia and thrombocytopenia.
For example, they might suggest stopping your medication or treating an ongoing infection and then monitoring your blood cell levels to see whether there’s a change.
Treatments can include:
- medication to promote blood cell production in your bone marrow
- corticosteroids or other immune system-suppressing drugs to treat an autoimmune disorder
- antibiotics or antifungal drugs to treat infections
- a blood transfusion to replace neutrophils or platelets
- intravenous immunoglobulin infusions to maintain neutrophil and platelet levels
- a bone marrow transplant to regrow bone marrow and stimulate the production of blood cells
Your outlook with neutropenia and thrombocytopenia depends on the cause. For example, low levels of blood cells due to chemotherapy might improve once you complete your treatment.
With that said, both conditions can cause severe complications, particularly without treatment. People with neutropenia may have an increased risk of developing a serious infection, and thrombocytopenia can cause life threatening internal bleeding.
If you have neutropenia, it means you don’t have enough neutrophils. Neutrophils are an important part of a healthy immune system, as they help to clear out viruses and bacteria and heal wounds. If you have neutropenia, you may be more likely to get infections.
If you have thrombocytopenia, you don’t have enough platelets, and your blood doesn’t clot as well as it should. You might experience skin discoloration, bruising, or increased bleeding.
These two blood cell deficiencies can occur together. This may be more likely if you have an infection, cancer, an autoimmune disorder, or take certain medications.