Question

The parents of a young patient currently being treated by your dental team inform you that following a length illness, their daughter has recently been diagnosed by her physician with a neutrophil defect. Neutrophils are also known as polymorphonuclear leukocytes. They inquire about any dental implication of this diagnosis. How might you respond to this inquiry.

Answer 1

Neutrophils are also known as polymorphonuclear leukocytes which are type of immune cell that has granules with enzymes that are released during infections, allergic reactions, and asthma. Neutrophils, eosinophils, and basophils altogether are polymorphonuclear leukocytes.

Neutrophil defect could be increase in neutrophil count which is called as neutrophilia or decreased neutrophil count known as neutropenia

1) Neutropenia is the decrease in white blood cell count. Neutropenia can develop suddenly over a few hours or days (acute neutropenia), or it can develop gradually and last for months or years (chronic neutropenia).

There are 2 main reasons for the development of  neutropenia :

- if existing neutrophils are destroyed faster than they can be replaced, or

- if the production of neutrophils in the bone marrow is reduced.

a) the first cause could be the result of infections, allergic disorders, certain drugs, autoimmune diseases where certain antibodies damages our own neutrophils and result in neutropenia, and in case of spleen diseases also there could be neutropenia.

b) the second cause could be the result of bonemarrow suppression in case of cancer treatment modalities, viral infections like influenza, bacterial infections such as tuberculosis, myelofibrosis, or deficiencies of vitamin B12 or folic acid.

2) Neutrophilia: Increase in neutrophil count than the normal range is called as neutrophilia

Neutrophilia is caused primarily in response to the bacterial infections, any acute inflammation and some drugs can also leads to neutrophilia.

So, with the above mentioned scenario it is purely after the infammatory process of dental infections as the body initiates the defence mechanisms. This could be explained to the patient's attenders about the normal physiological response of the human body and the levels will reduce once the rate of infection settles down and to reconfirm the level of neutrophils, a repeat sample can be taken during follow up visits.