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Should ICD10 WHO D70 Agranulocytosis code be mapped to Neutropenia instead of Agranulocytosis?

Vocabulary Users
#1

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look, in ICD10 Agranulocytosis includes Neutropenia,
but it should be the other way around of course, and ICD10CM does the good job though.

Should we remap ICD10 WHO D70 Agranulocytosis to Neutropenia?
@Alexdavv

#2

Hello @Dymshyts . Thank you for bringing this up, but remapping Agranulocytosis to Neutropenia would be incorrect. Agranulocytosis literally means the absence of granulocytes, but the term is often incorrectly used to indicate severe neutropenia. Agranulocytosis is a broader concept that includes neutropenia.
https://www.uptodate.com/contents/overview-of-neutropenia-in-children-and-adolescents?search=Agranulocytosis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.ncbi.nlm.nih.gov/mesh/68000380

#3

Agranulocytosis is a condition in which the absolute neutrophil count (ANC) is less than 100 neutrophils per microlitre of the blood

Neutropenia
The typical lower limit of the neutrophil count is about 1500 cells per microliter of blood (1.5 × 109 cells per liter). As the count goes below this level, the risk of infection increases. Neutropenia severity is classified as:

  • Mild: 1000 to 1500/mcL (1 to 1.5 × 109/L)

  • Moderate: 500 to 1000/mcL (0.5 to 1 × 109/L)

  • Severe: below 500/mcL (0.5 × 109/L)

So when it’s below 1500 it’s neutropenia,
when it’s below 100 it’s agranulocytosis.

So by this logic Neutropenia is more broad term which is reflected in ICD10CM as well

#4

This is a good one. And typical for medicine with its wishy washy nomenclatures, and no amount of pubmed dropping will fix that.

@TetianaOrlova is correct in that neutrophils are only part of granulocytes (the others being eosinophils and basophils), but they are by far the most. By that logic, agranulocytosis is the superior term.

@Dymshyts is correct in that in the clinic they are used pretty interchangeably, except the agranulocytosis is used for the more severe version. And that makes sense, if you have almost no granulocytes then your main problem is that you have no neutrophils. By that logic, the neutropenia is the superior term.

Since this is about Conditions diagnosed in the clinic I would go with @Dymshyts, as ugly as it is.

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