Neutropenia - a violation, the main characteristic of which is an abnormally low level of neutrophils in the blood. Neutrophils - a type of white blood cell, are produced by the bone marrow, and account for approximately 60% of the total number of blood cells. They play a critical role in immune responses, and are necessary to fight infections.

Essentially, neutrophils feed on bacteria, viruses, fungi and other microorganisms that can cause various diseases. Neutropenia is especially dangerous for cancer patients, as they have a weakened immune system, which means that the body is extremely vulnerable to infectious agents. Neutrophils are very sensitive to chemotherapy and radiotherapy; If the patient undergoes radiotherapy, the number of neutrophils destroyed will depend on the dose and dose of ionizing radiation, as well as how extensive area of ​​the body exposed to it.

Normal levels of neutrophils varies slightly depending on the age, as well as the human race. In infants the level of neutrophils lower than in older children and adults, and people of African descent it is lower than that of Europeans and Asians. The average level of neutrophils in adult human is 1500 units (cells per cubic millimeter of blood). In simplified form, the results of analyzes on neutrophils are interpreted as follows:

• More than 1,000 units - a normal defense against infections.
• 500-1000 - increased risk of infections.
• 200-500 - high risk of severe infections.
• Less than 200 units - very high risk of severe infection. The patient may require hospitalization.

In neutropenia have specific symptoms, other than those characteristic of infections which may occur with this disorder. If severe neutropenia, the patient can develop periodontal disease, ulcers of the mouth and rectum, bacterial pneumonia. Often patients observed a significant increase in body temperature. If after 19-30 days, the body temperature rises again, this may indicate a cyclic neutropenia.

To make a diagnosis, it is necessary to determine white blood cell count and differential diagnosis. Determine the cause of neutropenia may be difficult - it is necessary to study the patient's medical history, his family history, and sometimes also need a bone marrow biopsy.

In patients with cancer, neutropenia, an expected side effect of chemotherapy Chemotherapy - it always falls the hair?   Radiotherapy and Radiotherapy in cancer treatment: irradiation aid . The likelihood of developing severe infection depends on what kind of cancer sick people, and what treatment he passes. Particularly high risk for patients with leukemia and for those who do a bone marrow transplant.

It is important to identify the infection as early as possible. Their symptoms may include:

• Coughing and shortness of breath;
• Fever;
• Sweating;
• Chills;
• Swelling of the gums;
• Changes in the color of urine or stool;
• General malaise.

Causes

Reducing the production of white blood cells

Reducing the production of white blood cells - the most common cause of neutropenia. Development of white blood cells can be affected by the following reasons:

• Cancer - especially some varieties of leukemia
• Radiation

Drugs affecting bone marrow, including drugs used to treat cancer Cancer Treatment - difficult, but necessary   (chemotherapy drugs), chloramphenicol (Chloromycetin), antiepileptics and antipsychotics (chlorpromazine, proliksin and other phenothiazines). Transplantation of hematopoietic stem cells Stem cells: on the edge of scandal   (THC), the body is exposed to ionizing cure or potent drugs, and sometimes - both treatments designed to kill cancer cells. THC varieties are bone marrow transplantation and peripheral blood stem cells. During treatment with the cancer cells are destroyed or damaged and healthy bone marrow stem cells. As a result of stem cells can not get enough of immune cells, including - neutrophils, and developing neutropenia. To prevent this, before the treatment can be made stem cells of the bone marrow of the patient, which again will enter after the end of therapy. For these purposes may be used, and other stem cell donor.

Hereditary and congenital disorders affecting the bone marrow, including - family neutropenia, cyclic neutropenia and agranulocytosis newborns.

Exposure to pesticides.

Deficiency of vitamin B12 and folic acid.

The destruction of the white blood cells

The reasons are too rapid destruction of the white blood cells can be:

• Acute bacterial infection in adults;
• Infections in children;
• Certain autoimmune diseases such as systemic lupus erythematosus;
• Receiving drugs such as penicillin, phenytoin (Dilantin), and sulfonamide (Benemid, Bactrim, Gantanol).

Accelerated removal of leukocytes from the vascular

During these processes are derived from white blood cells of the vascular bed and spread to various body tissues. The reasons may be:

• Hemodialysis.
• Felty's syndrome, or malaria. In these diseases, neutrophils accumulate in the spleen.
• Bacterial infections. Neutrophils remain in the infected tissues and not be returned to the bloodstream.

It created a lot of methods of instrumental studies of the vascular bed. The most safe, non-invasive, painless and quick method is UZDG head and neck vessels. Duplex scanning of vessels allows us to estimate not only the state of the blood vessels (arteries and veins) and hemodynamic parameters. If the patient has neurological disorders, it is a direct indication for the survey.

How is the condition of vessels

Ultrasonography allows you to assess the condition of arteries and veins, that is, to conduct a detailed study of the vascular bed in the head and neck. Arterial system is available for inspection by the fact that the carotid arteries are located superficially. To suspect the presence of other changes in the blood vessels can be, if the study revealed characteristic lesions. First, we should pay attention to the thickening of the artery walls. This is one of the first indicators that reflects the tendency to the development of atherosclerotic lesions.

The formation of plaque is caused by the fact that the damaged inner shell is deposited macrophage cells, lipids, fibrin.

Plaque composition influences its stability (plaques may be frangible or resilient).

To assess the state of blood flow is important to determine the severity of the stenosis. If a person has the stenosis that closes the vessel lumen at 50% or more, it affects the process hemodynamics. There is a loss of power of different parts of the brain, as the compensatory capacity of the organism can not fully compensate for the violation caused by stenosis.

On the necessity of the study

There are certain indications for the purpose of this type of survey. Carotid ultrasonography should be performed for patients who have the following diseases:

• osteochondrosis Osteochondrosis - learn how to properly distribute the weight   (especially localized in the cervical region)
• hypertonic disease
• dizzy spells Dizziness - if the ground is slipping from under his feet , Transient ischemic attacks
• a history of stroke, that is previously transferred
• atherosclerosis
• visual disturbances (confirmed during ophthalmological research)

List of indications may be extended depending on the clinical picture of the disease, the patient's complaints. Similar problems often encountered doctors neurologists, internists, so their competence is the definition of indications for the study.

If a person is detected during a physical examination neurological symptoms, he complained of dizzy spells, headaches, the ultrasound head and neck vessels to be included in a comprehensive study plan. Before the study does not require additional training, so this is an advantage over other instrumental methods of diagnosis.

Headache is an absolute indication for ultrasound diagnostics of blood vessels, as it allows to detect vascular abnormalities.

When this type of survey is assigned to children

The big advantage of ultrasound is the absence of contraindications for it. The only contraindication may be the inability of the patient to take a horizontal position. Investigation is appointed, even a newborn to exclude the presence of congenital abnormalities, malformations.

Currently, often encountered in pediatric neurological problems. Timely detection of deviations makes ultrasound diagnosis of head and neck vessels. First of all, this kind of research helps to establish the diagnosis, a policy of effective therapy. Often the only sign of trouble is a headache, so parents should listen carefully to the complaints of child headache Headache: Causes and Complications Since it can serve as a precursor to more serious neurological disorders.

If a child in the neonatal period were manifestations of perinatal pathology, dynamic study should be carried out to assess the state of the vessels of the head and neck. This makes it possible to prevent the development of more gross violations, which often leads to the child's disability. Severe manifestations of disease occur in older adults, but it is necessary to prevent the development of childhood.

This method complements research vessels angiography, so both methods can be recommended as a comprehensive study. If the birth was difficult, proceeded with complications, it is necessary to examine the child during the first year of his life.

In the process of growth and development of the child is necessary to pay attention to the possible infringement of speech, attention or behavior, it should not be postponed examination if problems are detected. If you have a disease of the nervous system is a violation of cerebral circulation. Against the background of normalization of blood circulation, venous outflow comes the child's condition improved, but it depends entirely on the timely survey vessels of the head.

Marina Solovyov