Lymphocytopenia also known as lymphopenia develops when the lymphocyte count in the blood is lower than usual. Severely low or chronic low counts can signify a possible infection or illness that should be diagnosed and treated.

Lymphocytes are white blood cells, that are the main part of the immune system. These cells, mainly circulate in the blood and lymph fluid, and work to defend the body by attacking at the initial sign of invasion by pathogens. Lymphocytes also hold a vital role in triggering other immune responses and support the body’s immunity via past infections and vaccinations.
Lymphocytopenia

There are three types of lymphocytes that work together to detect and ward off infections and other diseases:

B cells produce antibodies and signalling proteins that attack invading bacteria, viruses, and toxins.

T cells communicate with B cells and find and destroy cells that have become infected or are cancerous

Natural Killer (NK) cells comprise compounds that can kill cancerous cells and cells infected with a virus

Very low levels of T cells or a few natural killers’ cell can result in uncontrolled viral, fungal, and parasitic infections. B-cell lymphocytopenia can lead to a rise in harmful and different types of infections.

Also Read:  Leukemia: Causes, Symptoms and Treatment

Causes

In most cases, lymphocytopenia is a sign of an underlying health condition, illness, or other factors, which is typically acquired than inherited.

T-cells make up the highest amount of lymphocytes, and T-cell lymphocytopenia is the most common, but this condition affects all three cell types.

Autoimmune Disorders

Autoimmune disorders develop when the immune system mistakenly attacks the body’s own cells and tissues resulting in:

Also, certain immunosuppressant drugs used to treat autoimmune disorders may cause lymphocytopenia.

Cancer

Hodgkin’s lymphoma, Kaposi sarcoma, and leukemia can result in low lymphocyte levels.

Cancer Treatment

Some of the cancer treatments may also cause lymphocytopenia, which includes:

Diseases that affect the blood and bone marrow can cause low lymphocyte levels:

  • Aplastic anemia
  • Lymphoproliferative disorders

Infections - viral, bacterial, parasitic, and fungal infections.

Lymphocytopenia can also be a sign of sepsis or acute bacteremia. Sepsis is a serious infection that leads to systemic inflammation and acute bacteremia is the presence of bacteria in the blood that can lead to sepsis, both conditions need immediate medical care.

Inherited Causes

Inherited causes of lymphocytopenia are very rare and some of the conditions include:

  • Ataxia-telangiectasia
  • DiGeorge syndrome
  • Combined immunodeficiency
  • Wiskott-Aldrich syndrome

Nutritional Causes

Malnutrition is the common cause of lymphocytopenia, which occurs when the body is deficient in protein and other vital nutrients required to produce lymphocytes. Anorexia nervosa is an eating disorder that may lead to decreased production of lymphocytopenia.

Gastrointestinal Conditions

Certain health conditions may damage the gut wall that can affect the body’s absorption of nutrients and may lead to lymphocytopenia in a few situations, which include:

  • Amyloidosis
  • Celiac disease
  • Crohn’s disease or ulcerative colitis
  • Regional enteritis
  • Zinc deficiency

Medications

Several medications can reduce lymphocyte levels and drug-induced lymphocytopenia ranges from mild to the severe form.

Kidney Disease

Kidney disease mainly end-stage chronic disease can decrease the number of T cells in the blood. Lymphocytopenia can also develop in acute kidney injury.

Trauma And Surgery

Trauma from an injury or acute emergency like cardiac failure can lower lymphocyte counts.

Other causes of lymphocytopenia include stress and alcohol overuse.

Symptoms

You may not observe any visible signs or symptoms of lymphocytopenia. However, in some cases, one may experience symptoms of the underlying cause or health condition, which may include:

  • Fever
  • Cough
  • Runny nose
  • Enlarged lymph nodes
  • Small tonsils
  • Joint pain
  • Skin rash
  • Night sweats
  • Sudden loss of weight

Diagnosis

The healthcare provider will initially get a complete blood count (CBC) blood test to determine lymphocyte level. Also, he may recommend a special blood test called a lymphocyte profile or lymphocyte subset panel to check the counts of T, B, and NK cells in the body.

Also Read: Complete Blood Count: What Is It And What To Expect?

If the lymphocyte count is below 1500 cells/microliter, then the doctor confirms the diagnosis of lymphocytopenia. Infants and children have more lymphocyte counts, so lesser than 2000 cells/ microliter is considered low for children under 6 years.

Treatment

Treatment depends on identifying the cause and treating the underlying factor helps to improve the condition. Patients may also require therapy to avert infections or other complications due to a compromised immune system.

If a drug is causing low counts, then your doctor may stop or change the medication. Drug-related lymphocytopenia usually improves after a person stops taking the drug.

Other treatment options include:

  • Antiretroviral combination therapy for HIV
  • Antivirals, antibiotics, antifungals, or antiparasitic drugs to treat specific infections
  • Gamma globulin helps prevent infections that can occur due to B-cell lymphocytopenia
  • Bone marrow stem cell transplant