Normal and Abnormal Absolute Neutrophil Count

The absolute neutrophil count (ANC) measures how many neutrophil granulocytes in a person’s blood. Doctors and lab technicians calculate ANC based on the number of white blood cells, often combined on the percentage of mature and immature neutrophils. Immature neutrophils are known as bands. The count can be too low or too high, caused by a variety of possible health conditions.

What Is Absolute Neutrophil Count?

It is measured indirectly by multiplying the white blood cell count times the percent of neutrophils in the differential of the white count. A normal range for ANC is 1.5 to 8.0, which translates to 1500 to 8000/mm3. When a patient’s level is safe, it means no activities need to be restricted.

Sample Calculation

WBC count: 6,000 cells/mm3 of blood

Segs: 30% of the WBCs

Bands: 3% of the WBCs

Neutrophils (segs + bands): 33% of the WBCs

ANC: 33% X 6,000 = 2,000/mm3

ANC of 2,000/mm3, by convention = 2.0

Normal range: 1.5 to 8.0 (1,500 to 8,000/mm3)

Interpretation: Normal

Functions

Neutrophils are responsible for helping the body fight against infection. When neutrophils are low, a person becomes vulnerable to illness and infection. This sometimes occurs following chemotherapy or radiation treatment, or a blood or marrow transplant. Over time it should rise as new blood cells develop and mature.

Low Absolute Neutrophil Count

An ANC of less than 500 is said to have a low. Many things can cause a low neutrophil count. The condition is called neutropenia.

Causes

• B12 or Folic Acid Deficiency. Too little B12 in the system causes a depletion of neutrophils. When there is a deficiency, the body is unable to perform normally.
• Severe Bacterial Infection. Severe infections can destroy neutrophils. This typically occurs when pus forms in the blood.
• Aplastic Anemia. Aplastic anemia occurs when there is an abnormal decrease in cells in the blood, usually because bone marrow is malfunctioning. Damage can be caused by medication, radiation, or infection.
• Preleukemia and Leukemia. Leukemia is cancer that occurs in the blood that causes bone marrow to be replaced by white blood cells. Preleukemia occurs when there is a decrease in neutrophils, but full-blown cancer is not yet present.
• Autoimmune Diseases. This occurs when the body produces proteins known as antineutrophil that destroy neutrophils. An example of this occurs in patients who suffer from lupus.
• Hypersplenism. This condition causes an abnormal enlargement in the spleen and an increase in white blood cells. The spleen helps to ward off infection and removes old red blood cells.
• Felty’s Syndrome. This syndrome causes a group of abnormal cell changes and usually accompanies rheumatoid arthritis. This is another type of immune disorder.
• Cardiopulmonary Bypass. This procedure can cause a low neutrophil count. This is an operation that moves blood flow away from the heart an lungs to the aorta.
• Dialysis. Dialysis is used to support kidney function. It can trigger a low neutrophil count.
• Medication Effects. Some medications cause neutrophil counts to drop. Typically, medications used to treat allergies, psychosis, and vomiting are culprits.

Remedies

Treating neutropenia requires finding the underlying cause of the problem. Once it is determined why the count has dropped, a doctor will suggest the appropriate treatment. Options include:

• Administration. This tracks the white blood cell growth in the body.
• Antibiotics. These help fight infections that cause neutrophils to drop.
• Granulocyte Transfusions. This is a type of white blood cells that is filled with microscopic granules. A transfusion increases the number in the system.
• Corticosteroid Therapy. There are two hormones, glucocorticoids and mineralocorticoids, made by the outer portion of the adrenal gland. Both support neutrophil health.
• Intravenous Immune Globulin. This is used for cases of immune-mediated neutropenia.

High Absolute Neutrophil Count

When a neutrophil count rises above 8000 it is considered high.

Causes

• High Level Stress. Neutrophil counts rise when stress is placed on the body. It might be caused by exercise, nerves, or seizures.
• Sudden Bacterial Infection. The onset of a bacterial infection can damage or cause inflammation in tissues, which can spike neutrophil levels.
• Sudden Kidney Failure. Kidney failure causes a spike in neutrophil counts.
• Ketoacidosis. This occurs when acids and poisons are produced by the body. When the condition is chronic, it causes neutrophil levels to rise.
• Eclampsia. Eclampsia is rare, but it is very serious. It occurs when pregnant women experience convulsions as a result of a moderate or severe case of preeclampsia. This typically occurs in the second half of a pregnancy and includes the sudden onset of high blood pressure, high protein in the urine, and edema.
• Cancer. Neutrophil counts can rise when cancer spreads in the body.
• Hemolytic Anemia. This occurs when red blood cells are destroyed earlier than usual. These cells are responsible for carrying oxygen to the blood.
• Polycythemia Vera. This causes a long-term increase in red blood cells, but doctors are not sure why it occurs.
• Myeloid Metaplasia. This is a condition that causes bone marrow to grow in abnormal places in the body.
• Medication Effects. Some medications can trigger a spike in neutrophil counts. An example of this is corticosteroids (like what is used to raise numbers when they low). These medications behave in the same way a natural corticosteroid hormone would in the body. These hormones control the body’s use of nutrients and the salt and water content of urine.