Morning pseudoneutropenia
Morning pseudoneutropenia is a transient reduction in the measured neutrophil count from peripheral samples. This is noticed in some patients who are taking antipsychotic medication. Morning pseudoneutropenia is thought to be due to diurnal variation in the amount of circulating white blood cells and changes in the levels of hematopoietic cytokines and granulocyte colony stimulating factor (GCSF).[1] Antipsychotics may amplify the natural variation in these hematopoietic factors.[citation needed]
Neutropenia is a hematological disorder characterized by an abnormally low number of neutrophils in the blood. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defense against infections. There is some variability in the neutrophil counts depending upon when the sample is taken, where the blood sample is taken from, and the system used by the medical lab for measuring the blood cells, but any significant reduction in function or number below the appropriate range may predispose individuals to infections.[citation needed]
Case reports of such incidents are reported with clozapine,[2][3] risperidone,[4] and aripiprazole.[5]
These case reports suggest that the observed cases of the morning pseudoneutropenia did not proceed to become agranulocytosis which is a significant and dangerous side effect of some of antipsychotics. Hence it was suggested[6] that although the morning neutrophil count may appear low, if the antipsychotic medication were considered efficacious then white cell counts may be repeated in the afternoon prior to making a decision based only on the morning counts.[citation needed]
References[edit]
- ^ Jilma B, Hergovich N, Stohlawetz P, Eichler HG, Bauer P, Wagner OF (August 1999). "Circadian variation of granulocyte colony stimulating factor levels in man". British Journal of Haematology. 106 (2): 368–70. doi:10.1046/j.1365-2141.1999.01543.x. PMID 10460592.
- ^ Ahokas A, Elonen E (June 1999). "Circadian rhythm of white blood cells during clozapine treatment". Psychopharmacology. 144 (3): 301–2. doi:10.1007/s002130051008. PMID 10435399. S2CID 29904594.
- ^ Esposito D, Aouillé J, Rouillon F, Limosin F (October 2003). "Morning pseudoneutropenia during clozapine treatment". The World Journal of Biological Psychiatry. 4 (4): 192–4. doi:10.1080/15622970310029918. PMID 14608591. S2CID 21205778.
- ^ Singh, G.; Kodela, S. (2009). "Morning pseudoneutropenia during risperidone treatment". Case Reports. 2009: bcr0620080288. doi:10.1136/bcr.06.2008.0288. PMC 3029895. PMID 21686871.
- ^ Pinnaka S, Roberto AJ, Giordano A, Siller P, Lapidus K (September 2015). "Aripiprazole-Induced Transient Morning Pseudoneutropenia in an 11-Year-Old Male". Journal of Child and Adolescent Psychopharmacology. 26 (9): 858–859. doi:10.1089/cap.2015.0128. PMID 26397725.
- ^ Esposito D, Corruble E, Hardy P, Chouinard G (February 2005). "Risperidone-induced morning pseudoneutropenia". The American Journal of Psychiatry. 162 (2): 397. doi:10.1176/appi.ajp.162.2.397. PMID 15677612.