Neutropenia | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Normal neutrophil count is 2.0 – 7.5X10⁹/L

Neutropenia is classified as:

Mild neutropenia 1.0 – 1.8
Moderate neutropenia 0.5 – 1.0
Severe neutropenia < 0.5

Causes include:

Drugs:
- antipsychotic drugs
- carbimazole
- sulpha drugs
- NSAIDs
- bendroflumethiazide
- anticonvulsant
- H2 Blockers
Chemotherapy
Radiotherapy
Viral infection, acute sepsis
Auto-immune conditions

Assessment

Careful history and clinical examination for evidence of recurrent infection, medication causes, organomegaly.
Repeat FBC and request blood film
Auto-immune screen
Viral serology for HIV
Haematinics

Primary care management

Cases with mild asymptomatic neutropenia is not an indication for referral – chronic idiopathic neutropenia.

In cases of mild neutropenia, recommend annual FBC monitoring. Referral is indicated when neutrophil count falls to less <1.0

Who to refer

Immediate referral for admission

Patients with severe neutropenia with evidence of sepsis require admission via Combined Assessment Unit

Urgent referral

Neutropenia with concomitant cytopenia
Neutropenia in the presence of adenopathy or splenomegaly

Routine referral

Moderate neutropenia; persistent neutrophils of <1.0
Neutropenia in association with recurrent infection or other abnormal findings

Last reviewed: 01/10/2024

Next review date: 01/10/2026

Author(s): Muayed Lasebai, Ranjit Thomas, Paul Ames.

Version: 1.0