Leukopenia


Leukopenia from Greek λευκός leukos, meaning 'white', and πενία penia, meaning 'deficiency' is a decrease in the number of white blood cells leukocytes found in the blood, which places individuals at increased risk of infection

Neutropenia, a subtype of leukopenia, refers to a decrease in the number of circulating neutrophil granulocytes, the most abundant white blood cells The terms leukopenia and neutropenia may occasionally be used interchangeably, as the neutrophil count is the most important indicator of infection risk This should not be confused with agranulocytosis

Contents

  • 1 Causes
    • 11 Medical conditions
    • 12 Medications
  • 2 Diagnosis
  • 3 References
  • 4 External links

Causesedit

Medical conditionsedit

Low white cell count may be due to acute viral infections, such as a cold or influenza It has been associated with chemotherapy, radiation therapy, myelofibrosis, aplastic anemia failure of white cell, red cell and platelet production, stem cell transplant, bone marrow transplant, HIV, AIDS, and steroid use

Other causes of low white blood cell count include systemic lupus erythematosus, Hodgkin's lymphoma, some types of cancer, typhoid, malaria, tuberculosis, dengue, rickettsial infections, enlargement of the spleen, folate deficiencies, psittacosis, sepsis, Sjögren's syndrome and Lyme disease It has also been shown to be caused by deficiency in certain minerals, such as copper and zinc

Pseudoleukopenia can develop upon the onset of infection The leukocytes predominately neutrophils, responding to injury first start migrating toward the site of infection, where they can be scanned Their migration causes bone marrow to produce more WBCs to combat infection as well as to restore the leukocytes in circulation, but as the blood sample is taken upon the onset of infection, it contains low amount of WBCs, which is why it is termed "pseudoleukopenia"

Medicationsedit

Certain medications can alter the number and function of white blood cells

Medications that can cause leukopenia include clozapine, an antipsychotic medication with a rare adverse effect leading to the total absence of all granulocytes neutrophils, basophils, eosinophils The antidepressant and smoking addiction treatment drug bupropion HCl Wellbutrin can also cause leukopenia with long-term use Minocycline, a commonly prescribed antibiotic, is another drug known to cause leukopenia There are also reports of leukopenia caused by divalproex sodium or valproic acid Depakote, a drug used for epilepsy seizures, mania with bipolar disorder and migraine

The anticonvulsant drug, lamotrigine, has been associated with a decrease in white blood cell count1

The FDA monograph for metronidazole states that this medication can also cause leukopenia, and the prescriber information suggests a complete blood count, including differential cell count, before and after, in particular, high-dose therapy

Immunosuppressive drugs, such as sirolimus, mycophenolate mofetil, tacrolimus, ciclosporin, leflunomide and TNF inhibitors, have leukopenia as a known complication 2 Interferons used to treat multiple sclerosis, such as interferon beta-1a and interferon beta-1b, can also cause leukopenia

Chemotherapy targets cells that grow rapidly, such as tumors, but can also affect white blood cells, because they are characterized by bone marrow as rapid growing3 A common side effect of cancer treatment is neutropenia, the lowering of neutrophils a specific type of white blood cell4

Decreased white blood cell count may be present in cases of arsenic toxicity5

Diagnosisedit

Leukopenia can be identified with a complete blood count6

Below are blood reference ranges for various types leucocytes/WBCs7 The 25 percentile right limits in intervals in image, showing 95% prediction intervals is a common limit for defining leukocytosis

Referencesedit

  1. ^ Nicholson, R J; Kelly, K P; Grant, I S 25 February 1995 "Leucopenia associated with lamotrigine" BMJ Retrieved 16 June 2010 
  2. ^ "Leukopenia and thrombocytopenia induced by etanercept: two case reports and literature review" 52 1: 110–2 PMID 22286650 
  3. ^ "What causes low blood cell counts" Retrieved March 3, 2012 
  4. ^ "Managing a Low White Blood Cell Count Neutropenia" Retrieved March 3, 2012 
  5. ^ http://toxscioxfordjournalsorg/cgi/content/full/103/2/278
  6. ^ http://ibdcrohnsaboutcom/od/diagnostictesting/p/testwbchtm
  7. ^ Specific references are found in article Reference_ranges_for_blood_tests#White_blood_cells_2

External linksedit

  • 11-135a at Merck Manual of Diagnosis and Therapy Professional Edition


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