Symptoms of leukopenia

Written by Zhang Xiao Le
Hematology
Updated on November 16, 2024
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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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Written by Zhang Jun Jun
Endocrinology
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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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Written by Zhang Xiao Le
Hematology
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What are the dangers of leukopenia?

The risks associated with leukopenia mainly relate to the degree of leukopenia and the diseases causing the decrease. Mild leukopenia generally does not show significant symptoms. Moderate leukopenia can manifest as fatigue, while a sharp decrease in white blood cells primarily carries a risk of infection, with symptoms including fever. This is because white blood cells are the main cells for combating infection in the body, and a significant reduction can markedly weaken the immune response, making infections more likely to occur at various sites. Besides the degree of leukopenia, the risks brought about by the underlying causes of leukopenia also vary. For example, leukopenia caused by aplastic anemia carries a risk of bleeding, while leukopenia resulting from rheumatic autoimmune diseases can lead to joint damage and erythema.

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Written by Li Lang Bo
Endocrinology
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Is leukopenia severe?

The normal value of white blood cells in the human body is 4 to 10×10^9/L. White blood cells mainly consist of neutrophils and lymphocytes, along with some other types of eosinophilic and basophilic granulocytes. If the total white blood cell count decreases, generally falling below 4 to 10×10^9/L, it is referred to as leukopenia. Among these, neutrophils are the most related to the body's immune response. If neutrophils decrease to less than 1.5×10^9/L, it is defined as neutropenia, which is very serious. If neutropenia occurs, the resistance to infections is greatly lowered, making the body highly susceptible to various infections. Active treatment to increase white blood cells is necessary; otherwise, any infection may lead to severe conditions like septicemia and septic shock, which can even be life-threatening.

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Written by Zhang Jun Jun
Endocrinology
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What does a decrease in white blood cells mean?

Leukopenia indicates a decrease in the body's resistance. The most common causes of leukopenia are: First, viral infections, which often coincide with an increase in lymphocytes and a decrease in neutrophils. The second cause is severe bacterial infections. During severe bacterial infections, there is a significant reduction in white blood cells, which may even lead to a decrease in platelets. The third cause is primarily diseases of the hematologic system, where leukopenia is often accompanied by a reduction in other red blood cells and platelets. Other possible causes include drug-induced leukopenia, as medications can also lead to a decrease in white blood cells. Therefore, the primary approach to leukopenia is to clearly identify the cause, and then determine the next steps for treatment based on that cause.

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Written by Tang Zhuo
Endocrinology
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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.