In cases of severe neutropenia, cough and respiratory symptoms, perianal pain and tenderness, or acute abdominal pain often occurs and necessitates immediate medical assessment. Gingivitis is a serious problem often leading to periodontal disease and loss of permanent teeth. Lymphadenopathy and splenomegaly Lymphadenopathy and splenomegaly are common presentations of infectious, inflammatory, and hematologic diseases, particularly the lymphomas and leukemias. Bleeding Bleeding occurs as a consequence of thrombocytopenia, deficiencies of coagulation factors, or both. Thrombocytopenia usually presents as petechial bleeding that is first observed in the lower extremities.
Coagulation factor deficiencies more often cause bleeding into the gastrointestinal tract or joints.
Intracranial bleeding, however, can occur with a deficiency of platelets or coagulation factors and can be catastrophic. Thrombosis Thrombosis can be either venous or arterial. With venous thrombosis, swelling, tenderness, and pain beyond the obstruction usually occur, and embolization to the lungs is a frequent concern. Venous thrombosis usually follows inactivity or obstruction of venous flow or occurs with imbalances of coagulation factors.