What to check for the cause of leukopenia?

Written by Zhang Jun Jun
Endocrinology
Updated on September 17, 2024
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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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Written by Tang Zhuo
Endocrinology
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What are the dangers of leukopenia?

Leukopenia is a relatively common hematological disease that can occur at any age. It is characterized by a persistent peripheral blood white blood cell count below 4×10^9/L. The onset of the disease is mostly slow, with mild symptoms. Common symptoms include fatigue, palpitations, dizziness, and pharyngitis, making individuals more susceptible to pharyngitis or mucosal ulceration. Other symptoms include reduced appetite, limb soreness, insomnia, and frequent dreaming. Individuals with leukopenia are also more prone to viral and bacterial infections. Some infections can lead to severe symptoms such as high fever, chills, and body aches. However, if there is a significant decrease in the total number of white blood cells, with the absolute neutrophil count dropping below 0.5×10^9/L, this condition is referred to as neutropenia. In such cases, symptoms may include chills, high fever, sore throat, headache, joint pain, and in severe cases, it can even lead to death.

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Written by Zhang Jun Jun
Endocrinology
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How to treat leukopenia?

The treatment plan for leukopenia primarily depends on the cause of the decreased white blood cells. If the cause is related to blood cancer, further examinations like bone marrow biopsy are needed, followed by treatment of the primary disease. The second most common scenario is liver cirrhosis, which can lead to a decrease in all three blood cell lines, causing reduction in white blood cells, platelets, and hemoglobin. In such cases, treatment options may include splenectomy or the use of oral medications that increase white blood cell count. However, these treatments only address the symptoms and not the root cause, which is liver cirrhosis, thus the primary disease still requires treatment. The third scenario involves severe bacterial and viral infections, where a decrease in white blood cells indicates a serious condition, necessitating further antiviral or anti-infection treatments. (Please follow the guidance of a professional physician for medication use, and do not self-medicate.)

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Written by Yang Li
Endocrinology
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Why does pneumonia cause a decrease in white blood cells?

When the severity of pneumonia is very severe, there can also be a decrease in white blood cells, which often suggests a higher possibility of severe pneumonia. Additionally, another scenario is viral pneumonia, where a decrease in white blood cells can also occur due to viral infections. Furthermore, there are special cases of infection, such as tuberculosis or infections caused by Mycoplasma or Chlamydia, where the use of anti-infection medications might also lead to a decrease in white blood cells. Another situation is when a patient inherently has a low white blood cell count, leading to weakened immunity and subsequently contracting pneumonia. In such cases, white blood cell counts might also not be high. Hence, severe bacterial pneumonia and decreases in white blood cells are relatively common in viral infections.

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Written by Tang Zhuo
Endocrinology
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What are the causes of leukopenia?

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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Written by Zhang Xiao Le
Hematology
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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.