What are the causes of leukopenia?

Written by Tang Zhuo
Endocrinology
Updated on August 31, 2024
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When the white blood cell count in peripheral blood is below 4.0 times 10 to the ninth power per liter, it is termed leukopenia. According to the cause, it can be divided into the following three aspects: First, disturbance in the production of white blood cells, including reduced proliferation of stem cells or regeneration disorders. Second, excessive destruction of white blood cells, such as from infections or immunological factors, leading to increased destruction of white blood cells. Third, abnormal distribution of white blood cells, due to various reasons, causes an increase in white blood cells in the marginal pool and a decrease in the circulating pool, which can also lead to leukopenia.

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Symptoms of leukopenia

The symptoms of leukopenia vary with the severity of the decrease in white blood cells and the disease causing the leukopenia. Mild leukopenia generally has no significant clinical manifestations. With moderate leukopenia, patients often experience symptoms of fatigue. If there is a significant decrease in white blood cells, patients often present with fever since white blood cells are the main cells in the body's defense against infections. A significant decrease in white blood cells markedly lowers the patient's resistance, thus making them more susceptible to various infections, with fever being the most common symptom of infection. Furthermore, the clinical presentations also vary with the underlying disease causing the decrease in white blood cells. For example, diseases like aplastic anemia or acute leukemia, which cause a decrease in white blood cells, may lead not only to fever but also to significant fatigue and bleeding manifestations.

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What are the symptoms of leukopenia?

Leukopenia is a common hematological disorder that can occur at any age. It is defined as leukopenia when the total number of white blood cells in the peripheral blood consistently falls below four times ten to the ninth power per liter. The onset of this disease is usually gradual with mild symptoms such as fatigue, palpitations, dizziness, low fever, prone to pharyngitis or mucosal ulcerations, and also includes loss of appetite, limb fatigue, insomnia with frequent dreams, and a cold stomach and backache. It makes one more susceptible to viral and bacterial infections such as colds. If leukopenia is caused by an infection, common symptoms include high fever, chills, and body aches. If the total number of white blood cells is significantly reduced, with an absolute neutrophil count below 0.5 times ten to the ninth power per liter, it is referred to as neutropenia. In such cases, the patient may experience chills, high fever, sore throat, headache, joint pain, and in severe cases, even coma and death.

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What to check for the cause of leukopenia?

If there is a decrease in white blood cells, we mainly look at the total number of white blood cells and the absolute value of neutrophils in our routine blood test. The causes of leukopenia are inseparable from neutrophils, and can be mainly divided into three categories. The first category is a production defect of neutrophils, the second is excessive destruction and consumption of neutrophils, and the third is abnormal distribution of neutrophils. A major cause of decreased production of white cells and neutrophils is damage to hematopoietic stem cells by ionizing chemicals. Additionally, immune reactions and bone marrow diseases can also lead to decreased production. Another cause is a production defect due to maturation disorders in neutrophils within white blood cells, leading to reduced white blood cell production. Maturation disorders are mainly due to a lack of raw materials needed for white blood cell production. Excessive destruction and consumption of white blood cells are often due to immune factors. Immune factors are common in autoimmune diseases, thus such diseases can also lead to leukopenia. The last category, abnormal distribution, can be a severe infection that causes an abnormal distribution of white cells, retaining them alongside other substances, such as in patients with enlarged spleens, which can provoke leukopenia by causing granulocytes to be retained in circulation, especially in areas like the spleen.

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What causes leukopenia?

When the white blood cell count in the surrounding blood continuously remains below 4.0*10^9/L, we call this condition leukopenia. Typical symptoms of leukopenia include dizziness, fatigue, limb soreness, reduced appetite, and listlessness, although some patients may not exhibit any obvious clinical symptoms. The causes of leukopenia are very complex and can be classified into two main categories: primary and secondary. Primary leukopenia refers to cases where the cause is unknown, while secondary leukopenia refers to cases potentially caused by acute infections or physical and chemical factors, or diseases of the hematopoietic system, connective tissue diseases, allergic diseases, or genetic diseases, all of which may lead to a reduction in white blood cells.

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Treatment methods for leukopenia

First, it is necessary to identify the cause of leukopenia. Common causes include viral infections and poor bone marrow hematopoiesis, and some medications can also cause this condition. Therefore, symptomatic treatment mainly involves the use of medications that increase white blood cells. For mild leukopenia, oral medications commonly used include Li Xuesheng, squalene, and Vitamin B4 to promote the proliferation of white blood cells. In more severe cases, granulocyte colony-stimulating factors may be used. Of course, the main method of treatment still depends on the different causes of each patient. Once leukopenia occurs, it is necessary to go to the hospital for an examination to clearly determine the cause of the decrease in white blood cells, so that targeted treatment can be provided. (Please use medications under the guidance of a professional physician and do not self-medicate.)