Leukopenia

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	Leukopenia;
ICD-10	D70
ICD-9	288.0
DiseasesDB	32396
MeSH	C15.378.553.546

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2] Luke Rusowicz-Orazem, B.S.

Synonyms and keywords: Deficiency in WBC, deficiency in white blood cells, deficiency in leukocytes, low WBC, low white blood cells, low leukocytes, neutrophilic leukopenia, neutrophilic leukocytopenia, neutrophilic leucopenia, neutrophilic leucocytopenia, neutropenia, eosinophilic leukopenia, eosinophilic leukocytopenia, eosinophilic leucopenia, eosinophilic leucocytopenia, eosinophilopenia, basophilic leukopenia, basophilic leukocytopenia, basophilic leucopenia, basophilic leucocytopenia, basophilopenia, leukocytopenia, leucopenia, leukopaenia, lymphopenia, lymphocytopenia

Overview

Deficiency of absolute number of leukocytes, which may be granulocytes (neutrophils, eosinophils, basophils) or lymphocytes (T-cells, B-cells). The majority of cases of leukopenia are actually neutropenia since neutrophils constitute the majority of leukocytes. As the principal function of white cells is to combat infection, a decrease in the number of these cells can place patients at increased risk for infection. In pancytopenia, the other cell types in the blood (red blood cells and platelets) are similarly affected. Neutropenia is 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. However, neutropenia is more properly considered a subset of leukopenia as a whole. Low white cell counts are associated with chemotherapy, radiation therapy, leukemia (as malignant cells overwhelm the bone marrow), myelofibrosis and aplastic anemia (failure of white and red cell creation, along with poor platelet production). In addition, many common medications can cause leukopenia. Other causes of low white blood cell count include: Influenza, systemic lupus erythematosus, typhus, malaria, HIV, tuberculosis, dengue, Rickettsial infections, enlargement of the spleen, folate deficiencies and sepsis. Many other causes exist. Leukopenia can be identified with a complete blood count.

Classification

Leukopenia

Granulocytopenia

Reduced number of granulocytes

Lymphocytopenia

(aka Lymphopenia)
Reduced absolute number of lymphocytes (T-cells or B-cells)

Neutrophilic leukopenia

(aka neutrophilic leukocytopenia, neutrophilic leucopenia, neutrophilic leucocytopenia, neutropenia)
Absolute neutrophil count < 1.5 x 109/L

Eosinophilic leukopenia

(aka eosinophilic leukocytopenia, eosinophilic leucopenia, eosinophilic leucocytopenia, eosinophilopenia)
Reduced absolute number of eosinophils

Basophilic leukopenia

(aka basophilic leukocytopenia, basophilic leucopenia, basophilic leucocytopenia, basophilopenia)
Reduced absolute number of basophils

Causes

Causes by Organ System

Cardiovascular	Degenerative and inflammatory vasculopathies, Primary and secondary varicosis, Vein compression syndrome
Chemical/Poisoning	Aminosalicylic acid, Capreomycin sulfate, Herbal agent overdose , Irinotecan hydrochloride, Mayapple poisoning , Monosodium methanarsenate , O'higgins disease , Radium chloride, Strontium chloride, Valganciclovir hydrochloride
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Aflibercept, Alimemazine, Altretamine, Amoxicillin, Azacitidine, Benzene , Carboplatin, Cefaclor, Cefotaxime sodium, Cefpodoxime, Ceftazidime, Certolizumab pegol, Chemotherapy, Chlorpropamide, Cisplatin, Clobazam, Cyclophosphamide, Cytarabine, Dacarbazine, Dactinomycin, Dexrazoxane, Diethylpropion, Diphtheria, Diuretics, Docetaxel, Doxorubicin hydrochloride, Drug-induced granulocytopenias, Epirubicin hydrochloride, Ethosuximide, Exanthema subitum, Febuxostat, Felbamate, Flavoxate, Flurazepam hydrochloride, Flurbiprofen, Fulvestrant, Gemifloxacin mesylate, Guanidine, Hydroxychloroquine, Ifosfamide, Lenalidomide, Lincomycin hydrochloride, Lomustine, Lorcaserin, Loxapine, Megestrol, Melphalan, Mercaptopurine, Meropenem, Metaxalone, Methocarbamol, Milnacipran hydrochloride, Mitomycin c, Mycophenolate, Nabilone, Nilutamide, Nitisinone, Nitrous oxide , Olanzapine, Olaparib, Olsalazine, Oxaprozin, Oxazepam, Oxcarbazepine, Paclitaxel, Palbociclib, Penicillamine, Pergolide, Perphenazine, Pertuzumab, Pramipexole, Primaquine phosphate, Probenecid, Promethazine, Pyrimethamine, Rabeprazole, Radiotherapy, Repaglinide, Rifampin, Romidepsin, Rufinamide, Sirolimus, Spironolactone, Streptozocin, Sulindac, Tamoxifen, Teniposide, Thioguanine, Thiotepa, Thiothixene, Tiagabine, Tolazamide, Tolbutamide, Toremifene, Trimethadione, Vinblastine, Zonisamide
Ear Nose Throat	No underlying causes
Endocrine	Hypopituitarism, Hypothyroidism
Environmental	No underlying causes
Gastroenterologic	Alcoholism, Banti syndrome , Gaucher disease type 3 , Hypersplenism, Infectious hepatitis, Liver disease, Spleen disease
Genetic	Acute cholinergic dysautonomia , Chromosome 8, mosaic trisomy , Ghosal syndrome , Homologous wasting disease , Trisomy 8 mosaicism
Hematologic	Aplastic anemia, Banti syndrome , Benign familial neutropenia, Bone marrow damage, Cyclic neutropenia, Ehrlichia ewingii, Fanconi pancytopenia , Folate malabsorption, hereditary, Folic acid deficiency, Foscarnet sodium, Gaucher disease type 3 , Ghosal syndrome , Haemodialysis, Hyperdibasic aminoaciduria type 2 , Hyperglobulia, Hypersplenism, Hypopituitarism, Hypothyroidism, Interleukin 2, Iron deficiency anemia, Korovnikov syndrome , Kostmann syndrome, Leukemia, Lipid storage disease, Lymphocytopenia, Megaloblastic anemia, Methylmalonic acidemia , Myelodysplasia, Myeloproliferative disorders, Neutropenia, Osteomyelosclerosis, Paraproteinemia, Pernicious anemia, Pyridoxamine 5-prime-phosphate oxidase deficiency , Refractory anaemia with ringed sideroblasts , Septicaemia, Vitamin b12 deficiency
Iatrogenic	Chemotherapy, Haemodialysis, Radiotherapy
Infectious Disease	Brucellosis , Bullis fever syndrome , Chickenpox, Epstein-barr virus, Heartland virus, Heavy-chain diseases , Hiv, Infectious mononucleosis, Infectious hepatitis, Influenza, Junin virus , Kala-azar, Leishmaniasis , Malaria, Ornithosis, Paratyphus, Parvovirus b19, Poliomyelitis, Rickettsial infection, Sabia virus , Sars , Septicaemia, Thyrotoxicosis, Tick borne encephalitis, Toxoplasmosis, Tuberculosis, Tularemia, Typhoid fever, Varicella, Visceral leishmaniasis , Yellow fever
Musculoskeletal/Orthopedic	Bone marrow damage, Cachexia, Myelodysplasia, Myeloproliferative disorders, Osteomyelosclerosis, Poliomyelitis
Neurologic	Tick borne encephalitis
Nutritional/Metabolic	Nutrition deficiency
Obstetric/Gynecologic	No underlying causes
Oncologic	Leukemia, Malignant lymphomas, Mastocytosis , Tumor infiltration
Ophthalmologic	No underlying causes
Overdose/Toxicity	Alcoholism, Herbal agent overdose
Psychiatric	No underlying causes
Pulmonary	Sars , Tuberculosis
Renal/Electrolyte	Hyperglobulia, Paraproteinemia
Rheumatology/Immunology/Allergy	Autoimmune diseases, Felty syndrome, Rheumatoid arthritis, Sjogren's syndrome, Systemic lupus erythematosus
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Contraindicated Medications

Leukopenia is considered an absolute contraindication to the use of the following medications:

Methotrexate

References

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