What Is Lymphocytopenia?
Lymphocytopenia (LIM-fo-si-to-PE-ne-ah) is a
condition in which your blood has a low number of white blood cells called
lymphocytes (LIM-fo-sites).
These cells are made in the bone marrow along with
other kinds of blood cells. Lymphocytes help protect your body from infection.
Low numbers of lymphocytes can increase your risk for infection.
Overview
About 20 to 40 percent of all white blood cells are
lymphocytes. A normal lymphocyte count for adults usually is between 1,000 and
4,800 lymphocytes per microliter of blood. For children, a normal count usually
is between 3,000 and 9,500 lymphocytes per microliter of blood.
"Lymphocytopenia" refers to a count of less than
1,000 lymphocytes per microliter of blood in adults or less than 3,000
lymphocytes per microliter of blood in children.
There are three types of lymphocytes: B lymphocytes,
T lymphocytes, and natural killer cells. All of these cells help protect the
body from infection. Most people who have lymphocytopenia have low numbers of T
lymphocytes. Sometimes they also have low numbers of the other types of
lymphocytes.
Several factors can cause a low lymphocyte count,
such as:
- The body doesn't make enough lymphocytes.
- The body makes enough lymphocytes, but they are
destroyed due to an abnormal condition.
- The lymphocytes get trapped in the spleen or
lymph nodes. Lymphocytes normally pass through these organs into the
blood.
- A combination of the above factors.
A number of diseases, conditions, and factors can
cause the above problems that lead to lymphocytopenia. These causes can be
acquired or inherited.
"Acquired" means you aren't born with the condition,
but you develop it. One of the most common acquired causes of lymphocytopenia
is AIDS.
"Inherited" means your parents passed the gene for
the condition on to you. Inherited causes include DiGeorge anomaly,
Wiskott-Aldrich syndrome, severe combined immunodeficiency syndrome, and
ataxia-telangiectasia. These inherited conditions are rare.
Outlook
Lymphocytopenia can range from mild to severe. The
condition alone may not cause any signs, symptoms, or serious problems.
How long lymphocytopenia lasts depends on its cause.
The treatment for this condition also depends on its cause and severity. Mild
lymphocytopenia may not require treatment. If an underlying condition is
successfully treated, lymphocytopenia will likely improve.
If you get serious infections due to
lymphocytopenia, you may need medicines or other treatments.
What Causes Lymphocytopenia?
In general, lymphocytopenia (a low lymphocyte count)
occurs because:
- The body doesn't make enough lymphocytes.
- The body makes enough lymphocytes, but they are
destroyed due to an abnormal condition.
- The lymphocytes get stuck in the spleen or lymph
nodes.
A combination of these factors also may cause a low
lymphocyte count.
A number of diseases, conditions, and factors can
cause the problems that lead to a low lymphocyte count. These conditions can be
inherited (passed from parents to children), or they can develop at any
age.
Exactly how each disease, condition, or factor
affects your lymphocyte count isn't known. Sometimes, people have low
lymphocyte counts with no underlying cause.
Acquired Causes
A number of acquired diseases, conditions, and
factors can cause lymphocytopenia. Examples include:
- Infectious diseases, such as AIDS, viral
hepatitis, tuberculosis, and typhoid fever
- Autoimmune disorders, such as lupus
- Steroid therapy
- Blood cancer and other blood diseases, such as
Hodgkin's disease and
aplastic
anemia
- Radiation and chemotherapy (treatments for
cancer)
Inherited Causes
Certain inherited diseases and conditions can lead
to lymphocytopenia. Examples include DiGeorge anomaly, Wiskott-Aldrich
syndrome, severe combined immunodeficiency syndrome, and ataxia-telangiectasia.
These inherited conditions are rare.
Who Is At Risk for Lymphocytopenia?
People at highest risk for lymphocytopenia are
affected by one of the diseases, conditions, or factors that can lead to a low
lymphocyte count. This includes people who have:
- AIDS or other infectious diseases
- Autoimmune disorders
- Blood cancers or other blood diseases
- Certain inherited diseases or conditions
People at highest risk also include those who have
had steroid therapy or radiation or chemotherapy (treatments for cancer). For
more information, see "What Causes
Lymphocytopenia?"
What Are the Signs and Symptoms of
Lymphocytopenia?
Lymphocytopenia alone may not cause any signs or
symptoms. The condition usually is found when a person is tested for other
diseases or conditions, such as AIDS.
If you have unusual infections, repeat infections,
and/or infections that won't go away, your doctor may suspect that you have
lymphocytopenia. Fever is the most common symptom linked to infections.
How Is Lymphocytopenia Diagnosed?
Your doctor will diagnose lymphocytopenia based on
your medical history, a physical exam, and the results from tests.
Lymphocytopenia alone may not cause any signs or
symptoms. As a result, the condition often is diagnosed during testing for
other diseases or conditions.
Specialists Involved
Your primary care doctor may notice that you have
unusual infections, repeat infections, and/or infections that won't go away.
These may be signs of lymphocytopenia. Your primary care doctor may refer you
to an infectious disease specialist to find out what's causing the
infections.
You also may see a hematologist (blood disease
specialist) or an immunologist (immune disorders specialist). Blood diseases
and immune disorders can cause lymphocytopenia.
Medical History
To learn about your medical history and your risk
for a low lymphocyte count, your doctor may ask:
- About your risk for AIDS, including questions
about blood
transfusions, sexual partners, intravenous (IV) drug use, and exposure to
infectious blood or bodily fluids at work
- Whether you've ever received radiation or
chemotherapy (treatments for cancer)
- Whether you've ever been diagnosed with a blood
disease or immune disorder, or whether you have a family history of such
illnesses
Physical Exam
Your doctor will do a physical exam to look for
signs of infection, such as fever. He or she may check your abdomen for signs
of an enlarged spleen and your neck for signs of enlarged lymph nodes.
Your doctor also will look for signs and symptoms of
diseases and conditions that can affect your lymphocyte count, such as AIDS and
blood cancers.
Diagnostic Tests
Your doctor may order one or more of the following
tests to help diagnose a low lymphocyte count.
Complete Blood Count With Differential
A
complete
blood count (CBC) measures many different parts of your blood. It checks
the number of red blood cells, white blood cells, and platelets in your blood.
The CBC shows whether you have a low number of white blood cells.
Lymphocytes account for 20 to 40 percent of all
white blood cells. Although a CBC will show an overall low white blood cell
count, it won't show whether the number of lymphocytes is low.
You may need a more detailed test, called a CBC with
differential, to see whether you have a low lymphocyte count. This test shows
whether you have low levels of different types of white blood cells, such as
lymphocytes. The results of this test can help your doctor diagnose
lymphocytopenia.
Flow Cytometry
This test looks at many types of blood cells. It's
even more detailed than a CBC with differential.
Flow cytometry can measure the levels of the
different types of lymphocytesT cells, B cells, and natural
killer cells. This can help diagnose the underlying cause of lymphocytopenia.
Some underlying conditions cause low levels of T cells. Others may
cause low levels of B cells or natural killer cells.
Tests for Underlying Conditions
A number of diseases and conditions can cause
lymphocytopenia. Thus, your doctor will want to find out what's causing the
condition. You may be tested for HIV/AIDS, tuberculosis, blood diseases, and
immune disorders.
Tests for these underlying conditions might include
blood
tests,
bone
marrow tests, and lymph node tests.
Lymph nodes are part of the immune system. They're
found in many places in your body. During a physical exam, your doctor may find
that certain lymph nodes are swollen. In lymphocytopenia, the lymph nodes may
hold on to too many lymphocytes and not release them into the bloodstream.
To test a lymph node, you may need to have it
removed. This involves a minor surgical procedure.
How Is Lymphocytopenia Treated?
If you have mild lymphocytopenia with no underlying
cause, you may not need any treatment. The condition may improve on its
own.
If you have unusual infections, repeat infections,
and/or infections that won't go away due to lymphocytopenia, you'll need
treatment for the infections.
If you have a disease or condition that's causing
lymphocytopenia, your doctor will prescribe treatment for that illness.
Treating the underlying problem will help treat the lymphocytopenia.
Treatment for Infections
Low levels of lymphocytes make it harder for your
body to fight infections. You may get infections caused by viruses, fungi,
parasites, or bacteria.
Treatment for the infections will depend on their
causes. You also may need treatment after an infection is gone to help prevent
future infections.
Children who have serious bacterial infections that
keep coming back may get a medicine called immune globulin. This medicine helps
boost their immune systems and fight the infections.
Treatment for Underlying Diseases or
Conditions
A number of diseases and conditions can cause
lymphocytopenia. Examples include infectious diseases, such as AIDS; blood
diseases, such as
aplastic
anemia; and inherited diseases, such as Wiskott-Aldrich syndrome.
Your treatment will depend on your underlying
disease or condition.
Emerging Treatments
Researchers are looking at ways to increase
lymphocyte production in people who have lymphocytopenia with serious
underlying conditions.
For example, some studies are looking into
blood
and marrow stem cell transplants. Conditions that cause the body to not
make enough blood cells, including lymphocytes, may cause lymphocytopenia. A
blood or marrow stem cell transplant may help treat or cure some of these
conditions.
Other studies are looking at medicines and other
substances that can help the body make more lymphocytes.
Talk to your doctor about whether a clinical study
might benefit you.
How Can Lymphocytopenia Be Prevented?
You can't prevent lymphocytopenia that's due to an
inherited cause. However, you can take steps to control the condition. Follow
your treatment plan and take all medicines as your doctor advises.
You may be able to lower your risk for acquired
lymphocytopenia by lowering your risk for the conditions that cause it. For
more information about acquired causes of the condition, see
"What Causes Lymphocytopenia?"
Living With Lymphocytopenia
If you have mild lymphocytopenia with no underlying
condition, you may not need treatment. The lymphocytopenia may improve on its
own.
If an underlying condition is causing your
lymphocytopenia, you'll need treatment for that condition. You'll also need
treatment for infections if your body is unable to fight them due to
lymphocytopenia.
Treating and Preventing Infections
The main risk of lymphocytopenia is getting unusual
infections, repeat infections, and/or infections that won't go away. If you
have lymphocytopenia, you may get treatment to prevent infections or to treat
infections you already have.
You also can take other steps to prevent infections.
For example:
- Stay away from people who are sick, and avoid
large crowds of people.
- Avoid certain kinds of foods that can expose you
to bacteria, such as uncooked foods.
- Wash your hands often.
- Brush and floss your teeth and get regular dental
care to reduce the risk of infection in your mouth and throat.
- Ask your doctor whether you should get a yearly
flu shot and the
pneumonia
vaccine.
It's important to know the signs of infection, such
as fever. Call your doctor right away if you think you have an infection.
Living With Underlying Conditions
If you have a disease or condition that causes
lymphocytopenia, you need to get treatment for that condition.
You'll probably have regular tests to see how the
treatment is working. For example, you may have
blood
tests to check the level of lymphocytes in your blood.
If the treatments for the underlying condition are
working, the level of lymphocytes in your blood may go up.
Physical Activity
Talk to your doctor about what types and amounts of
physical activity are right for you. You may want to avoid activities that
could result in injuries or increase your risk for infections.
Key Points
- Lymphocytopenia is a condition in which your
blood has a low number of white blood cells called lymphocytes.
- Lymphocytes help protect your body from
infection. When your blood has a low number of lymphocytes, you have an
increased risk for infection.
- A normal lymphocyte count for adults usually is
between 1,000 and 4,800 lymphocytes per microliter of blood. For children, a
normal count usually is between 3,000 and 9,500 lymphocytes per microliter of
blood.
- A count of less than 1,000 lymphocytes per
microliter of blood in adults or less than 3,000 lymphocytes per microliter of
blood in children is lower than normal.
- In general, a low lymphocyte count develops for
one or more of these reasons:
- The body doesn't make enough
lymphocytes.
- The body makes enough lymphocytes, but they
are destroyed due to an abnormal condition.
- The lymphocytes get stuck in the spleen or
lymph nodes.
- A number of diseases, conditions, and factors can
cause the problems that lead to lymphocytopenia. These conditions can be
inherited or acquired. The inherited conditions are rare. A common acquired
cause of lymphocytopenia is AIDS.
- Lymphocytopenia alone may not cause any signs or
symptoms. The condition usually is found when a person is tested for other
diseases or conditions, such as AIDS. If you have unusual infections, repeat
infections, and/or infections that wont go away, your doctor may suspect
that you have lymphocytopenia.
- Your doctor will diagnose lymphocytopenia based
on your medical history, a physical exam, and tests results.
- Treatment for lymphocytopenia depends on its
cause and severity. Mild lymphocytopenia with no underlying cause may not
require treatment. If you have unusual infections, repeat infections, and/or
infections that won't go away due to lymphocytopenia, you'll need treatment for
the infections.
- You can't prevent lymphocytopenia that's due to
an inherited cause. You may be able to lower your risk for acquired
lymphocytopenia by lowering your risk for the conditions that cause it.
- The main risk of lymphocytopenia is infections.
If you have lymphocytopenia, take steps to prevent infections and report any
signs of infection to your doctor right away. Fever is the most common sign of
infection.
Links to Other Information About
Lymphocytopenia
Non-NHLBI Resources
Clinical Trials
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