Author Ольга Кияница
Leukopenia (LP) is a condition in which a person reduces the amount of leukocytes. This increases the risk of infectious infection. There are many reasons for leukopenia. Some of them are associated with some drugs, cancer, radiation and chemotherapy for cancer treatment. In other cases, the risk factor is stem cell transplantation, surgical intervention, the use of steroids or autoimmune diseases.
Most often leukopenia develops on the background of antitumor therapy. In such cases, one of the side effects is neutropenia (subtype of leukopenia). [1 - "Managing a Low White Blood Cell Count (Neutropenia)". Retrieved March 3, 2012]
Leukopenia is simply diagnosed, but it is not always possible to effectively treat it. This basically depends on the general condition of the patient and the underlying disease or the root cause of which developed LP. In spite of this, it is necessary to carry out appropriate therapy, since without it the immune system does not cope with infections at all, which as a result can lead to serious complications.
Blood of man consists of many different types of cells, the so-called blood cells. White blood cells, also known as white blood cells (white blood cells), help fight infection. Leukocytes are a vital part of the immune system.
Leukopenia is a medical term that characterizes a low number of leukocytes.Normally, the number of leukocytes ranges from 3500 to 11,000 BKT per microliter. This indicator is often different between sexes and different age groups. In a person with leukopenia may be less than 3500 leukocytes per microliter.
Leukocytes are produced in the bone marrow and are crucial for the immune system. With their deficiencies, there are problems with getting rid of infections, viruses or bacteria. For the effective treatment of the pathological condition, the root cause of leukopenia should be determined.
There are five types of leukocytes.Everyone helps protect the body from a specific type of infection:
- Neutrophils: They account for 55-70% of all leukocytes. Help fight against fungal and bacterial infections.
- Lymphocytes: This is the second most common type of leukocytes. They protect the body from viral infections.
- Basophils: the least common type of leukocytes. They participate in inflammatory reactions to various allergens.
- Monocytes: the largest of leukocytes. They play a role in the fight against bacteria, mushrooms and viruses. Also involved in the restoration of tissue that was damaged by inflammation.
- Eosinophils: They fight against parasites and play an important role in the development of allergic reactions and bronchial asthma.
There are five types of leukopenia, each of which corresponds to the type of leukocytes that are affected. The most famous is neutropenia.
The terms "leukopenia" and "neutropenia" are often used interchangeably. However, they characterize several distinct pathological processes.
Leucopenia is a generalized term that refers to the reduction of the amount of any type of white blood cell.
Neutropenia is a type of leukopenia, but refers specifically to the decrease of neutrophils, the most common type of leukocytes.
A bit of leukopenia statistics
- In developed countries, LP occurs in 3.5% -15% of the 1 million population.
- In European countries, 2 new cases of LP are recorded per year for 1 million people.
- In Africa and Asia, the incidence rate of leukopenia is 3 times higher than in Europe.
- After 60 years, leukopenia is less common in men than in women.
There are 10 major causes of leukopenia, which most often contribute to the development of a pathological condition.
1. Congenital disorders
Some congenital diseases contribute to a decrease in the number of neutrophils:
- Kostman's syndrome is a hereditary disease of the bone marrow, in which children are born without enough neutrophils. This leads to suffering from frequent bacterial infections.
- Myelocaethexis is an hereditary disease of white blood cells, which causes severe leukopenia and, in particular, neutropenia.
2. Viral infections
Some viruses violate the function of the bone marrow that produces leukocytes. They can also slow down the work of the bone marrow, which leads to leukopenia.
3. Diseases of the bone marrow, injury or injury
When the bone marrow is damaged or injured, it can lead to either insufficient production of blood cells such as BKT, or cause overproduction of one kind of BKT. Bone marrow diseases include:
- Folate deficiency or vitamin B12 deficiency
- Myeloproliferative disorders
- Myelodysplastic syndrome
- Aplastic anemia
The effects of certain toxins, chemicals, radiation, chemotherapy, and some drugs can damage or injure the bone marrow. When there is damage to it, blood cells are produced in less quantities, leading to anemia and leukopenia. Certain nutrients are needed for the correct functioning of the bone marrow.
Leukopenia may occur when the bone marrow is enlarged. Low levels of leukocytes are also observed in other types of cancer, such as lymphoma and leukemia. Thus, the ability of the bone marrow to produce normal blood cells is limited.
Complications in the treatment of cancer are another reason for low rates of leukocytes. The amount of BKT is significantly reduced when chemotherapy is given to people with cancer. In bone marrow cancer, very low production of neutrophils may occur, which leads to leukopenia.
The bone marrow is suppressed during chemotherapy and radiation, so patients undergoing cancer treatment are more susceptible to infections. In order to prevent serious complications due to the low amount of leukocytes, the treatment is corrected and changed.
In this disorder, premature destruction of blood cells in an organ like a spleen occurs. Such a process leads to anemia and leukopenia. The function of the spleen is to get rid of the old uniform blood elements, but in the case of excessive spleen, the removal of cells is accelerated even when they are still functioning normally.
6. Preventing infections
Reserves of BKT can be exhausted due to serious infections. Some severe infectious diseases can cause life-threatening complications called sepsis.
Drugs can damage the bone marrow and, in particular, leukocytes. There are a number of drug groups that cause leukopenia. These include:
- Antipsychotic medications such as clozapine
- Anti-epileptic drugs including lamotrigine and sodium valproate
- Interferons used for the treatment of multiple sclerosis
- Immunosuppressive drugs for transplant patients such as syrrolimus, tacrolimus, cyclosporine and mycophenolate mofetil
- Antibiotics such as minocycline and penicillin, which can also cause leukopenia
8. Autoimmune disorders / diseases of the immune system
Such disorders create favorable conditions under which the immune system mistakenly damages healthy cells and tissues in the body. With autoimmune disorders, the immune system destroys normal white blood cells, which leads to leukopenia. An example of an autoimmune disease is systemic lupus erythematosus.
The amount of leukocytes in the body can also be reduced due to HIV / AIDS. When HIV infection, leukocytes are attacked, which makes the immune system weaker. Thus, the body's ability to fight with the easiest infection is lost.
9. Nervous anorexia
Another cause of leukopenia is nerve anorexia. In this disorder, abnormally low body mass is observed due to deliberate starvation. According to the University of Virginia Health Services, many anorexia patients have low levels of leukocytes. Leukopenia occurs due to frequent vomiting and limited diet. Consequently, the bone marrow does not get enough of the nutrients necessary for the body to produce the desired amount of BKT.
This is a systemic disorder characterized by the formation of a granule in some parts of the body. When these granulomas are determined in the bone marrow, this can significantly disrupt the production of leukocytes.
Other causes of leukopenia development:
- Thyroid gland diseases
- Parasitic infections
- Rheumatoid arthritis
- Typhoid fever
- Dengue fever
- Rickettsia infections
- Deficiency of minerals, such as copper and zinc
There are no specific symptoms that indicate the presence of low levels of leukocytes. However, when a person has leukopenia, then the chance of getting infected increases. Therefore, the symptoms of an infectious disease are most commonly defined:
In a person with leukopenia, there may be other symptoms that are associated with the underlying cause of LP.
Additionally, the following features can be determined:
- Inflammation of the lungs due to infection with bacteria or viruses that cause pneumonia. As a result, the symptoms characteristic of the disease develop: fever, chest pain, shortness of breath, noisy breathing.
- Inflammation of the mucous membrane of the gums, cheeks, lips, tongue, etc., which manifests itself as redness, swelling, bleeding in the affected areas.
- Long and severe menstruation.
- Bleeding from the uterus of an infectious genesis.
- Signs of neurasthenia: fatigue, fever, headache, irritability and outbreaks of anger.
- Strong desire to consume hot drinks.
- Ulcerative lesions of the oral cavity: inflammation of the throat, lips or tongue.
The patient firstly makes a general blood test, which determines not only leukopenia, but also other disorders:
- Anemia: when a person shows signs of iron deficiency.
- Thrombocytopenia: a decrease in the number of platelets due to the presence of damage in the bone marrow.
Also, ultrasound of the internal organs can be performed, which can detect liver abscesses in the presence of bacterial infection in the body. Such a pathology is often combined with leukopenia.
Video Clinical Blood Test - School of Dr. Komarovsky
There are several tactics for treating leukopenia:
- Elimination or reduction of the specific cause causing leukopenia, for which the treatment of the underlying disease is carried out.
- If the drug contributes to the development of leukopenia, the doctor may recommend that you stop taking it or use another medicine. In this case, the patient should never stop acquiring or changing previously prescribed medications independently without first consulting the physician.
- If cancer is being treated and leukopenia has arisen in the course of chemotherapy, then it may be necessary to pause such treatment until the normal amount of leukocytes is restored.
Treatment, which involves the use of growth factors, such as granulocyte colony stimulating factor, may improve the course of leukopenia. Such tactics are often used in chemotherapy that causes leukopenia, or if the cause lies in genetic disorders.
A study conducted in 2015 showed that with chemotherapy, along with a drug called erlotinib (a tyrosine kinase inhibitor), the risk of leukopenia was significantly lower.
The following recommendations can help the patient with leukopenia to improve their health and reduce the risk of infection:
- It is necessary to adhere to the rules of hygiene, in order to avoid infection
- It is important to practice the basics of a healthy diet
- It is necessary to avoid cuts and scratches
- Have more rest
In case of any infectious diseases that arise due to the reduction of the number of leukocytes, additional treatment may be performed. It mainly includes antibiotics or antifungal agents.
Leukocytopenia is not a fatal pathology. However, in a patient's unfavorable condition, this may contribute to the appearance of some complications. In particular, the risk of developing various infections in the body increases. This can be:
- respiratory infections
- viral diseases;
- HIV, etc.
Their development represents a danger to the patient in the long run.
Video Complications of Anemia
There are some foods that should be included in the diet to prevent the development of leukopenia.
Zinc is an immune buffer. He participates in the production of leukocytes and reduces the risk of infection. Contained in such products as oysters, beef, lamb, wheat germ and spinach.
2. Folic acid
Folic acid is very essential in the production of red blood cells and leukocytes. Its deficiency can lead to anemia and leukocytopenia, respectively. Contained in spinach, beans and citrus.
3. Dairy products
Skim milk, cheese and yogurt should be used more as these foods are rich in protein. They will increase the production of leukocytes in the body. You can also eat eggs and cooked dishes.
4. Green tea
A drink can help get rid of toxins. Thus, it prevents the development of the infection and improves the working capacity of the immune system. Tea acts as an antioxidant.
Garlic contains a large amount of zinc, which is an important part of the immune system. It also helps fight infections.
6. Fruits and vegetables
To prevent leukopenia, it is useful to have oranges, melons, carrots, spinach and other green leafy vegetables. They help to increase the amount of leukocytes in the body.
They need to be used for nutritionally rich vitamins. Vitamin A and vitamin C are important elements in the generation of leukocytes in the body.
Echinacea and astragalus grass can be used. These plants stimulate the activity of the immune system, as they are rich in vitamins. But you need to consult a doctor before taking these herbs, because some patients develop allergic reactions. It is recommended to take them in the form of injections.
Every day you need to drink clean enough water. It will cleanse the body and strengthen the immune system. This will prevent the occurrence of leukopenia.
Video Blood leukocytes are lowered