A sore throat is one of the symptoms of neutropenia - abnormally low concentration of neutrophils
Aetiology
DMARDs
If patient who is on a DMARD presents with rash, oral ulceration, nausea/vomiting, diarrhoea, dry cough, or new onset/increasing dyspnea should have treatment withheld and specialised advice taken
In the event of a severe sore throat or abnormal bruising, treatment should be withheld, an urgent FBC taken and any blood test abnormalities discussed with specialist team
Provide symptomatic relief
Consider prescribing an antibiotic, taking into account potential interactions with DMARDs
Other causes
Drugs like carbimazole can cause idiosynchratic neutropenia
Chemotherapy, known/suspected leukaemia, asplenia, anaplastic anaemia or HIV with low CD4+, or is taking an immunosuppressive drug following a transplant
Management
Urgent FBC and withhold drug (if applicable) until result is avaliable
Seek specialist advice
Consider prescribing an antibiotic, taking into account potential interactions e.g. with DMARDs
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