Lymphopenia is a temporary or permanent decrease in the level of lymphocytes in the blood to a level of 1500 / mm3 and below. If lymphopenia is present in a person for a long period of time, then this can lead to the development of an opportunistic infection. Lymphopenia itself indicates a pathological process in the body, which can be very serious, up to oncology.
Lymphocytes are white blood cells, which are a type of white blood cell. They act as elements that make up the general structure of immunity. Lymphocytes are present in the blood on a permanent basis. These cells are located in the lymph nodes, in the thymus, in the spleen, in the lymphoid tissue of the intestinal walls and in the bone marrow.
- Lymphopenia symptoms
- Lymphopenia causes
- Diagnosis of lymphopenia
- Lymphopenia treatment
Lymphopenia is not an independent disease, therefore, there are no specific symptoms of a decrease in the level of lymphocytes in the blood.
The general symptoms of infection entering the body are an increase in body temperature, pallor of the skin, erosion and ulceration of the mucous membranes of the oral cavity and intestines. The patient will experience weakness and malaise, his working capacity decreases. If lymphopenia is persistent, then the person will suffer from frequent infections that are difficult to treat. With a significant decrease in the level of lymphocytes in the blood, severe complications may develop, up to sepsis and death.
The causes of lymphopenia are as follows:
Severe viral infection. If a person suffers from any disease for a long time, then the reserve reserves of immune cells will eventually be depleted. After a temporary lymphocytosis, the patient will experience an acute deficiency of lymphocytes in the body. If treatment is started on time and the infection can be eliminated, the level of these cells will recover. When there is no treatment, a person can die from complications of the disease due to the failure of the immune system.
Depletion of bone marrow reserves. Some diseases cause depletion of bone marrow reserves. In this case, a person will suffer not only from lymphocytopenia, but also from a deficiency of all blood cells, since it is this organ that is primarily responsible for their growth and development.
Such diseases include:
- Fanconi's anemia. This is a congenital disease, which is accompanied not only by lymphopenia, but also by a decrease in the level of erythrocytes, platelets and all white blood cells. In this case, congenital defects are often observed: the absence of thumbs on the hands, short stature, hearing loss. Patients die from severe infections or massive bleeding. The likelihood of developing cancerous tumors is also high. Therapy is possible, but a complete cure cannot be achieved without a bone marrow transplant.
- Radiation effect on the body. Irradiation occurs under the confluence of unfavorable circumstances, or it can be targeted, during the course of a treatment course. When exposed to radiation, the bone marrow begins to be replaced by connective tissue. She is unable to reproduce blood cells, which leads to the development of lymphopenia. In parallel, the level of all blood cells falls.
Taking certain medications. Medicines that can provoke the development of lymphopenia include antipsychotics and cytostatics. A decrease in the level of lymphocytes is indicated in the instructions for their use as a side effect. Corticosteroid therapy can cause relative lymphopenia, and the level of neutrophils is often reduced to critical levels.
Terminal stage of heart and renal failure.
Lymphogranulomatosis. In Hodgkin's lymphoma, abnormal cells are located in the lymph nodes. At the same time, they increase in size, the patient develops anemia, and the likelihood of bleeding increases. At night, a person is worried about sweating, he begins to lose weight, his body temperature rises. The painful sensations will be caused by the pressure of the growing tumor on the tissue.
Immunodeficiency states. Immunodeficiency states can develop throughout life, or be congenital pathologies. If there is a deficiency of T-lymphocytes, then this can be detected using a routine blood test. When there is a decrease in the number of B-lymphocytes, then additional examination methods are required.
These conditions include:
- DiGeorge syndrome (thymic hypoplasia). In this case, the child has congenital malformations of the facial bones, heart defects, cleft palate, etc. The severity of lymphocytopenia depends on the degree of damage to the thymus.
- Severe combined immunodeficiency. This disease is genetic. With it, damage to both cellular and humoral immunity occurs. The child will begin to suffer from manifestations of pathology almost from birth. Serious illnesses with serious complications (pneumonia, sepsis, skin infections, etc.) come to the fore. Even the most harmless diseases can lead to the death of a child.
AIDS. The human immunodeficiency virus enters the body and begins to infect T-lymphocytes. Infection occurs either during mixing of the biological fluids of a sick and healthy person, or during pregnancy and childbirth, when the virus is transmitted from mother to child. The first symptoms will appear several years after infection. Lymphopenia will progress, the body will no longer fight infections on its own, the likelihood of sepsis and death increases. Also, the risk of developing cancer remains high, since the T-lymphocytes fighting cancer will be destroyed by the virus.
Diagnosis of lymphopenia
To diagnose lymphopenia, a person needs to see a general practitioner. The doctor will prescribe him to take a clinical blood test. In the laboratory, a doctor can observe lymphocytes in a blood smear when stained with Romanovsky dye. Lymphocytes have a transparent cytoplasm inside which a dense nucleus is located. Depending on the amount of cytoplasm, small and large lymphocytes are distinguished. Normally, a liter of adult blood contains 1.5-4.0 * 10 9 lymphocytes. If their number is lower, then we can talk about lymphopenia.
After this fact is established, it is necessary to determine the reasons that provoked this violation. To do this, the doctor will send the patient for an additional examination, which will clarify the diagnosis and prescribe treatment.
Lymphopenia does not require any specific treatment, as this condition is not an independent disease. To increase the level of lymphocytes to normal values, it is necessary to eliminate the cause that caused such a violation. After that, the level of lymphocytes in the blood will return to normal on its own.
To get rid of the patient from severe inflammatory reactions and to improve the quality of the blood, he is prescribed immunoglobulins G. The dose is calculated based on the formula 0.4 g of immunoglobulin per kilogram of weight. The drug is administered once every 7 days.
It is necessary to abandon the use of immunoglobulins if severe adverse reactions develop. Treatment with immunoglobulins can provoke a sharp drop in blood pressure, collapse, or allergic reactions. When a person has diseases of a congenital nature and it is they that cause lymphopenia, immunoglobulins are not used for treatment.
To get rid of Fanconi's anemia, the patient will need a bone marrow transplant. Temporary relief and delay of complications is possible by taking glucocorticosteroids. The average life expectancy for people with Fanconi anemia is 30 years.
If lymphopenia was provoked by taking medications, then, if possible, such therapy should be abandoned. After some time, the level of lymphocytes will recover.
If lymphopenia is caused by lymphogranulomatosis, then the patient is prescribed cytostatics with further radiation exposure to the lymph nodes. Provided that a relapse occurs, the patient is prescribed aggressive chemotherapy and waiting for a bone marrow donor for his transplant. Typically, about 85% of these patients overcome the five-year survival line. The prognosis is less favorable when the disease is diagnosed at the terminal stage, or the patient's age exceeds 45 years.
DiGeorge's syndrome in a child requires either a thymus or bone marrow transplant. This is especially true for patients with complete and not partial syndrome. If there is no such treatment, then the patient will die from infectious diseases.
Severe combined immunodeficiency is treated only with a bone marrow transplant. If the operation is performed in the first 3 months of a child's life, then there is a chance for a complete recovery of the baby. When there is no treatment, children do not live longer than 2 years.
HIV infection requires antiretroviral therapy. This allows you to contain the disease and prolong a person's life. Complete cure of HIV is currently impossible.
Doctors and parents should be especially alert when the level of lymphocytes is low in a small child. Normally, the counts of these blood cells in children are even higher than in adults. Therefore, lymphopenia in a child should be the reason for checking the baby's allergic status or diagnosing congenital diseases.
Lymphopenia requires a comprehensive examination of the patient. If you ignore this symptom, then you can waste time and not notice how a dangerous disease develops in the body. After all, lymphocytes are the most important cells that are responsible for the formation of the human immune system. Therefore, if you have any complaints and symptoms of discomfort, you must consult a doctor to take a blood test.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".