When to suspect an autoimmune cause of neutropenia?

Madeleine Verhovsek, MD, is an associate professor in the Department of Pathology and Molecular Medicine at McMaster University.

When should an autoimmune cause of neutropenia be suspected? What tests should be ordered then?

That’s a very good question. Autoimmune leukopenia can happen for a lot of different reasons, sometimes associated with other medical issues.

The main way we would know if somebody had an autoimmune leukopenia would be, for sure, if they had another diagnosis, such as lupus or rheumatoid arthritis—that may be a clue.

The other reason we might suspect autoimmune lymphopenia, or leukopenia, or neutropenia might be if we do other investigations and there’s no cause identified.

The testing would really be guided by clinical decision making, clinical judgment, including completing a full history, physical exam, and then deciding on whether serology testing, such as antinuclear antibody (ANA) or rheumatoid factor (RF) [testing], may be useful.