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| {{Infobox_Disease | | | {{Infobox_Disease | |
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| | MeshID = D008231 | | | MeshID = D008231 |
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| {{SI}} | | {{Lymphocytopenia}} |
| {{CMG}} | | {{CMG}} |
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| {{Editor Help}} | | {{SK}} Lymphocytopenia; lymphopenia; lymphocyte count low (peripheral blood) |
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| ==Overview==
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| '''Lymphocytopenia''', or '''lymphopenia''', is the condition of having an abnormally low level of [[lymphocytes]] in the blood. [[Lymphocytes]] are a white blood cell with important functions in the immune system. The opposite is [[lymphocytosis]], which refers to an excessive level of [[lymphocyte]]s.
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| ==Differential diagnosis of causes of lymphocytopenia==
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| Lymphocytopenia can be caused by various types of [[chemotherapy]], such as with cytotoxic agents or immunosuppressive drugs. Some malignancies in the [[bone marrow]] also cause lymphocytopenia.
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| People exposed to large doses of [[radiation]], such as those involved with Chernobyl, can have severe lymphocytopenia.
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| A decreased number of certain types of lymphocytes, notably [[T cell]]s, is a characteristic of [[AIDS]].
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| [[Idiopathic]] CD4+ lymphocytopenia is the condition of having an abnormally low level of CD4+ T-cells. It has no known cause<ref name="smithdk">{{cite journal | author=D K Smith, J J Neal, and S D Holmberg | title=Unexplained opportunistic infections and CD4+ T-lymphocytopenia without HIV infection. An investigation of cases in the United States | journal=[[The New England Journal of Medicine]] | volume=328 | issue=6 | pages=429-431 | pmid=8093633}}</ref> and is not associated with AIDS or any known infectious agent such as [[HIV]] or [[HTLV]].<ref name="hodd">{{cite journal|author=D D Ho, Y Cao, T Zhu, C Farthing, N Wang, G Gu, R T Schooley, and E S Daar | title=Idiopathic CD4+ T-lymphocytopenia — immunodeficiency without evidence of HIV infection | journal=[[The New England Journal of Medicine]] | volume=328 | issue=6 | pages=386-392 | date=1993-02-11 | pmid=8093634}}</ref> It is associated with higher risks of opportunistic infections and cancer.<ref name="spira">{{cite journal | author=Thomas J Spira, Bonnie M Jones, Janet Nicholson, Renu B Lal, Thomas Rowe, Alison C Mawle, Carl B Lauter, Jonas A Shulman, and Roberta A Monson | title=Idiopathic CD4+ T-Lymphocytopenia — An Analysis of Five Patients with Unexplained Opportunistic Infections | journal=[[The New England Journal of Medicine]] | volume=328 | issue=6 | pages=386-392 | date=1993-02-11 | pmid=8093635}}</ref>
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| Lymphocytopenia may be present as part of a [[pancytopenia]], when the total numbers of all types of blood cells are reduced. This can occur in marrow failure.
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| Lymphocytopenia, but not idiopathic CD4+ lymphocytopenia, is associated with [[corticosteroid]] use, infections with [[HIV]] and other [[viral]], [[bacterial]], and [[fungal]] agents, [[Hodgkin's disease]], [[leukemia]], [[malnutrition]], [[systemic lupus erythematosus]],<ref name="">{{cite journal | author=W L Ng, C M Chu, A K L Wu, V C C Cheng, K Y Yuen | title=Lymphopenia at presentation is associated with increased risk of infections in patients with systemic lupus erythematosus | journal=Quarterly Journal of Medicine | volume= 99 | issue=1 | pages=37-47 | doi=10.1093/qjmed/hci155}}</ref> high [[stress (medicine)|stress]] levels, whole body radiation, [[rheumatoid arthritis]], and [[iatrogenic]] conditions.
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| In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| * After [[Influenza|influenza]]
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| * After [[Snakebites|snakebite]]
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| * [[Anesthesia]]
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| * Antibody deficiency syndrome
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| * [[Aplastic Anemia]]
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| * [[Banti's Syndrome]]
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| * [[Burns]]
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| * Congenital immune deficiency
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| * [[Cushing's Disease]]
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| * [[Dermatomyositis]]
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| * [[Drugs]], toxins
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| * [[Exudative enteropathy]]
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| * [[Felty's Syndrome]]
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| * Heavy [[exercise]]
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| * [[HIV]]
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| * [[Hodgkin's Lymphoma]]
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| * [[Inflammatory Bowel Disease]]
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| * Lymphocyte [[tuberculosis]]
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| * [[Measles]]
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| * [[Paroxysmal nocturnal hemoglobinuria]]
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| * [[Polycythemia]]
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| * Postoperative
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| * [[Pregnancy]]
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| * [[Sarcoidosis]]
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| * [[Scarlet Fever]]
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| * Secondary [[hypersplenism]]
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| * Single non-Hodgkin's [[lymphoma]]s
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| * [[Surgery]]
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| * [[Systemic Lupus Erythematosus]]
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| * [[Trauma]]
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| * [[Tuberculosis]]
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| * [[Uremia]]
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| * [[Whipple's Disease]]
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| * [[Zinc deficiency]]
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| | ==[[Lymphocytopenia overview|Overview]]== |
| | ==[[Lymphocytopenia historical perspective|Historical Perspective]]== |
| | ==[[Lymphocytopenia classification|Classification]]== |
| | ==[[Lymphocytopenia pathophysiology |Pathophysiology]]== |
| | ==[[Lymphocytopenia causes|Causes]]== |
| | ==[[Lymphocytopenia differential diagnosis|Differentiating Lymphocytopenia from other Diseases]]== |
| | ==[[Lymphocytopenia epidemiology and demographics|Epidemiology and Demographics]]== |
| | ==[[Lymphocytopenia risk factors|Risk Factors]]== |
| | ==[[Lymphocytopenia screening|Screening]]== |
| | ==[[Lymphocytopenia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| ==Diagnosis== | | ==Diagnosis== |
| | [[Lymphocytopenia history and symptoms|History and Symptoms]] | [[Lymphocytopenia physical examination|Physical Examination]] | [[Lymphocytopenia laboratory findings|Laboratory Findings]] | [[Lymphocytopenia chest x ray|Chest X Ray]] | [[Lymphocytopenia CT|CT]] | [[Lymphocytopenia MRI|MRI]] | [[Lymphocytopenia other imaging findings|Other Imaging Findings]] | [[Lymphocytopenia other diagnostic studies|Other Diagnostic Studies]] |
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| * Lymphocytopenia is diagnosed from the results of a [[complete blood count]].
| | ==Treatment== |
| | | [[Lymphocytopenia medical therapy|Medical Therapy]] | [[Lymphocytopenia surgery|Surgery]] | [[Lymphocytopenia primary prevention|Primary Prevention]] | [[Lymphocytopenia secondary prevention|Secondary Prevention]] |
| * In adults, a [[lymphocyte]] level below 1.500 cells/microliter is suspected and below 1000 cells/microliter is diagnostic.
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| * In children, a [[lymphocyte]] level below 3.000 cells/microliter is diagnostic.
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| ==Prognosis== | | ==Case Studies== |
| Lymphocytopenia that is caused by infections tends to resolve once the infection has cleared. Patients with idiopathic CD4+ lymphocytopenia may have either abnormally low but stable CD4+ cell counts, or abnormally low and progressively falling CD4+ cell counts; the latter condition is terminal. | | [[Lymphocytopenia case study one|Case #1]] |
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| == References ==
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| {{Reflist|2}}
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| ==External links==
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| * [http://www.merck.com/mmhe/sec14/ch174/ch174d.html Merck]
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| * [http://www.healthatoz.com/healthatoz/Atoz/ency/lymphocytopenia.jsp Health A-Z]
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| == Acknowledgements ==
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| The content on this page was first contributed by C. Michael Gibson, M.S., M.D.
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| List of contributors:
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| ----
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| == Suggested Reading and Key General References ==
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| == Suggested Links and Web Resources ==
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| == For Patients ==
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| {{Hematology}} | | {{Hematology}} |
| {{SIB}}
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| [[Category:Blood disorders]] | | [[Category:Disease]] |
| [[Category:Immune system disorders]] | | [[Category:Immunology]] |
| [[Category:Signs and symptoms]]
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| [[Category:Hematology]] | | [[Category:Hematology]] |
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