The feedback from low white blood cells (more properly: low leukocytes, Low WBC or leukopenia) is not uncommon, and is often linked to the presence of neutropenia (low neutrophilic granulocytes). The causes of low leukocytes they are disorders of bone marrow production, neoplasms, but also numerous drugs, acute inflammatory states and infections, especially viral. THE symptoms of low white blood cells they are generally asthenia (tiredness), malaise, ease of getting infections. Very often, however, there is no specific symptom associated with low white blood cells.
What are leukocytes?
What are white blood cells? THE white blood cells or leukocytes (in English WBC, that is white blood cells) they are very important cells, necessary for the defense of our organism from attacks by foreign agents or organisms such as bacteria, viruses, parasites and fungi (fungi).
White blood cells are divided into numerous subtypes, classified according to the shape of the nucleus and the response to specific colors used for viewing under the microscope.
There leukocyte formula, that does not is none other than the percentage determination of the various cell types of leukocytes present in the peripheral smear of our blood, it is mainly composed of lymphotics and granulocytes. Let's see in detail the composition of the leukocyte formula.
- Polymorphonuclear granulocytes account for the majority of total leukocytes, and are so named for the presence of characteristic granulations in the cytoplasm (which is the liquid contained in the cells) and a polylobed nucleus (i.e. with many lobes). The granulocytes are represented by neutrophil granulocytes (60% of total white blood cells), i basophilic granulocytes (About 1% of total leukocytes) and i eosinophilic granulocytes (Approximately 5% of total white blood cells).
- Mononuclear agranulocytes instead they represent about 35% of total white blood cells, and are characterized by a rounded nucleus and by the scarcity or absence of granules in the cytoplasm. The main types of mononuclear leukocytes are i lymphocytes (30% of total white blood cells) ei monocytes (Approximately 6% of total WBCs), which are the circulating cells from which i macrophages.
In turn, i lymphocytes they are divided into sub-categories with very diversified functions:
- THE B lymphocytes, i.e. plasma cells, are the lymphocytes responsible for the production of antibodies and the activation of T lymphocytes.
- THE T lymphocytes They are divided into T Helper lymphocytes, essential for the activation and modulation of the immune response of other lymphocytes, and i cytotoxic T lymphocytes, which have a direct action on bacteria, viruses and other hostile agents to the organism.
Low leukocytes - Low white blood cells - Leukopenia values
THE low leukocyte values (leukopenia) are values less than 4 * 10 ^ 9 / l, i.e. less than 4 billion white blood cells per liter of blood.
In some laboratories this number is expressed as 4,000 leukocytes / mm3 or ml, that is, values less than four thousand white blood cells per cubic millimeter or milliliter of blood.
Low White Blood Cells Causes - Low White Blood Cells Causes - Leukopenia Causes
What are the main causes of leukopenia (i.e. the causes of low white blood cells in the blood)?
The main ones causes of low leukocytes I'm:
- Blood tumors, which damage the bone marrow and impair the production of blood cells:
- Leukemia: they are distinguished according to the rapidity of expression (acute leukemias and chronic leukemias), as well as according to the type of cells affected (myeloid leukemias and lymphatic or lymphoid leukemias.
- Lymphomas: they are a kind of solid leukemia, with the disease mainly affecting the organs of the immune system such as lymph nodes, spleen and intestinal immunological stations.
- Myelodysplasia: myelodysplasia, more correctly defined myelodysplastic syndrome it is a blood disease caused by damage to one or more stamina cells present inside the bone marrow. Damaged stem cells therefore fail to produce adequate amounts of functioning blood cells, resulting in a shortage of red blood cells, white blood cells and / or platelets. There are various types of myelodysplastic syndromes. In a certain percentage of cases, myelodysplastic syndromes develop into a more aggressive form of haematological disease, the acute myeloid leukemia.
- Myeloproliferative syndromes: diseases of the blood derived from a diseased stem cell, with uncontrolled proliferation of the pathological clone, include various types of blood pathology, including chronic myeloid leukemia (CML, often classified as leukemia instead of myeloproliferative), polycythemia vera (PV ), essential thrombocythemia (TE), and idiopathic myelofibrosis (MFI).
- Neoplasms: the presence of tumors that damage the bone marrow directly (by proximity) or distantly (with metastases) can lead to bone marrow hypoplasia or aplasia, with leukopenia and possible anemia (low red blood cells) and thrombocytopenia (low platelets).
- Myelofibrosis: progressive replacement of the bone marrow with fibrotic material. In addition to idiopathic myelofibrosis, which we have seen before, a picture of myelofibrosis sometimes represents the terminal phase of leukemia, lymphomas and other cancers. It is characterized by bone marrow hypoproduction, with leukopenia, lymphopenia and neutropenia, associated with anemia and thrombocytopenia (low platelets).
- Congenital or acquired disorders which alter the hematopoietic function of the bone marrow, decreasing its productivity, and leading to the finding of reduced leukocytes, often also with low erythrocytes and reduction of platelets. For example
- Aplastic anemia: hypoproduction of all types of circulating cells by the marrow, causing a condition of pancytopenia. It can be genetic or acquired.
- Paroxysmal nocturnal hemoglobinuria: is an acquired hematopoietic cell disease characterized by haemolytic anemia, bone marrow failure and frequent thrombotic episodes of the great vessels.
- Medicines that damage circulating leukocytes:
- Antibiotics, such as minocycline (Minocin), trimethoprim-sulfamethoxazole (Bactrim) sulfasalazine (Salazopyrin)
- Antipsychotics, such as clozapine (Leponex)
- Antidepressants such as bupropion (Wellbutrin)
- Antiepileptics such as valproic acid (Depakin)
- Antithyroid drugs like tapazole
- Monoclonal antibodies such as Rituximab (Mabther
- Medicines or therapies which interfere with the hematopoietic function of the bone marrow
- chemotherapy: all chemotherapy drugs they can cause neutropenia and lymphopenia, as well as low eosinophils and low basophils.
- chronic therapy with corticosteroids.
- immunosuppressants: azathioprine, methotrexate, cyclosporine, everolimus, tacrolimus: these are all drugs that depress the immune system and can cause leukopenia.
- Radiation or radiation therapy: irradiation with ionizing rays at the medullary or neighboring level can result in a reduced functionality of the latter. Even in cases of nuclear disasters, such as Chernobyl or Fukushima, the very high concentration of radiation present in the surrounding area has increased the incidence of blood diseases, with bone marrow hypoproduction and even fatal.
- Autoimmune Diseases which reduce bone marrow production of blood cells
- Arthritis rheumatoid
- Autoimmune hyperthyroidism (e.g. Graves' disease)
- Systemic lupus erythematosus
- Myasthenia gravis
- Infections which determine a broad cell consumption and destruction blood, including leukocytes;
- HIV: Human Immunodeficiency Virus, is the virus that causes the justly feared Acquired Immunodeficiency Syndrome, or AIDS.
- Dengue: hemorrhagic fever, characterized by fever and hemorrhagic manifestations
- Infections (especially acute viral infections) that alter the bone marrow function:
- HIV: the HIV virus damages both the circulating cells and the bone marrow directly.
- Hepatitis B: HBV infection can inhibit proper bone marrow hematopoiesis, resulting in a drop in white blood cells.
- CMV infection: cytomegalovirus can impair bone marrow production
- EBV infection: Epstein Barr Virus also behaves like CMV.
- Tuberculosis: especially if with vertebral or medullary localization.
- Sepsis: Although infections normally cause an increase in white blood cells (leukocytosis), a severe infection can also be characterized by low white blood cells (see the old sepsis criteria).
- Parasitic or protozoal diseases
- GVHD: Graft Versus Host Disease, graft versus host disease, is a form of rejection after transplantation of
- Hypersplenism: Entrapment and / or premature destruction of circulating blood cells within the spleen, which appears enlarged and hypertrophic. The enlarged spleen is frequent in blood disorders such as leukemia, lymphomas, myelodysplasias and lymphoproliferative syndromes, but also in diseases such as liver cirrhosis.
- Vitamin deficiencies, such as folate and vitamin B12 (cyanocobalamin): the deficiency of these substances essential for the growth of circulating blood cells often causes a reduction in leukocytes, with simultaneous megaloblastic anemia.
- Deficiencies of trace elements: the lack of substances such as zinc and copper can lead to a reduction in leukocytes.
- Kostmann syndrome, a congenital disorder characterized by reduced synthesis of neutrophils (a particular type of white blood cell)
- Myelocatessi: myelocathexis is a congenital disorder (present from birth) characterized by the failure of neutrophils to enter the bloodstream, with consequent leukopenia.
Low white blood cells symptoms - Low white blood cells symptoms - Leukopenia symptoms
What are the symptoms of low white blood cells? The main symptoms of low leukocytes I'm:
- asthenia: tiredness, weakness in common daily activities
- weight loss, weight loss
- frequent infections
- bone pains
- frequent bleeding, even spontaneous
- pale skin, lips and nails
- Jaundice (yellow skin) and high bilirubin: in case of liver disease or paroxysmal nocturnal hemoglobinuria, hyperbilirubinemia manifests itself with the accumulation of bilirubin on the skin tissues, with the appearance of yellow / green color of the skin
- Abdominal pain
- Hepatomegaly: enlarged liver
- Splenomegaly: enlarged spleen
- Ascites: presence of fluid in the abdomen (peritoneal cavity)
- Headache: headache.
- Frequent bleeding, especially gum bleeding or epistaxis (nosebleeds).
- Renal failure: finding of high creatinine following overload of the lysis products of red blood cells and defective white blood cells in the kidneys.