What are the symptoms of leukopenia?

Written by Tang Zhuo
Endocrinology
Updated on September 23, 2024
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Leukopenia is a common hematological disorder that can occur at any age. It is defined as leukopenia when the total number of white blood cells in the peripheral blood consistently falls below four times ten to the ninth power per liter. The onset of this disease is usually gradual with mild symptoms such as fatigue, palpitations, dizziness, low fever, prone to pharyngitis or mucosal ulcerations, and also includes loss of appetite, limb fatigue, insomnia with frequent dreams, and a cold stomach and backache. It makes one more susceptible to viral and bacterial infections such as colds. If leukopenia is caused by an infection, common symptoms include high fever, chills, and body aches. If the total number of white blood cells is significantly reduced, with an absolute neutrophil count below 0.5 times ten to the ninth power per liter, it is referred to as neutropenia. In such cases, the patient may experience chills, high fever, sore throat, headache, joint pain, and in severe cases, even coma and death.

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Endocrinology
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What causes leukopenia?

Leukopenia mainly has the following three causes: 1) Drugs; 2) Infections; 3) Diseases that cause disturbances in white blood cell production. Drugs primarily include antibiotics such as sulfonamide antibiotics and penicillin; anti-tuberculosis drugs like rifampicin and isoniazid; anti-thyroid drugs such as methimazole and propylthiouracil; antipyretic analgesics like aminopyrine, indomethacin, and ibuprofen; and antihistamines such as diphenhydramine. Additionally, most chemotherapy drugs can cause a decrease in white blood cells. Viral infections can lead to a decrease in white blood cells or severe bacterial infections, such as sepsis and septicemia, along with some chronic infections. Diseases that cause disturbances in the production of white blood cells mainly refer to certain hematological diseases, such as aplastic anemia or malignant tumors that invade the bone marrow and affect hematopoiesis. Furthermore, there are some less common causes of leukopenia, such as familial inheritance and granulocyte distribution disorders.

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Symptoms of leukopenia

The symptoms of leukopenia vary with the severity of the decrease in white blood cells and the disease causing the leukopenia. Mild leukopenia generally has no significant clinical manifestations. With moderate leukopenia, patients often experience symptoms of fatigue. If there is a significant decrease in white blood cells, patients often present with fever since white blood cells are the main cells in the body's defense against infections. A significant decrease in white blood cells markedly lowers the patient's resistance, thus making them more susceptible to various infections, with fever being the most common symptom of infection. Furthermore, the clinical presentations also vary with the underlying disease causing the decrease in white blood cells. For example, diseases like aplastic anemia or acute leukemia, which cause a decrease in white blood cells, may lead not only to fever but also to significant fatigue and bleeding manifestations.

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Written by Tang Zhuo
Endocrinology
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Leukopenia is a condition.

Leukopenia is defined as a condition in which the white blood cell count in peripheral blood persistently remains below 4 times 10 to the ninth power per liter. Since the components of white blood cells are mainly neutrophils and lymphocytes, particularly dominated by neutrophils, leukopenia is mostly caused by a decrease in neutrophils. The causes of leukopenia can be categorized into primary and secondary types. Primary leukopenia refers to cases where the cause is unknown, while secondary leukopenia could be due to acute infections, physical or chemical factors, or certain diseases such as hematologic disorders, connective tissue diseases, allergic diseases, or genetic disorders. In addition, there are also some acquired or idiopathic cases of granulocytopenia that fall under the category of leukopenia. Typical symptoms of leukopenia include dizziness, fatigue, muscle weakness, reduced appetite, and mental sluggishness.

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Endocrinology
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What to check for the cause of leukopenia?

If there is a decrease in white blood cells, we mainly look at the total number of white blood cells and the absolute value of neutrophils in our routine blood test. The causes of leukopenia are inseparable from neutrophils, and can be mainly divided into three categories. The first category is a production defect of neutrophils, the second is excessive destruction and consumption of neutrophils, and the third is abnormal distribution of neutrophils. A major cause of decreased production of white cells and neutrophils is damage to hematopoietic stem cells by ionizing chemicals. Additionally, immune reactions and bone marrow diseases can also lead to decreased production. Another cause is a production defect due to maturation disorders in neutrophils within white blood cells, leading to reduced white blood cell production. Maturation disorders are mainly due to a lack of raw materials needed for white blood cell production. Excessive destruction and consumption of white blood cells are often due to immune factors. Immune factors are common in autoimmune diseases, thus such diseases can also lead to leukopenia. The last category, abnormal distribution, can be a severe infection that causes an abnormal distribution of white cells, retaining them alongside other substances, such as in patients with enlarged spleens, which can provoke leukopenia by causing granulocytes to be retained in circulation, especially in areas like the spleen.

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What medicine is used for leukopenia?

Leukopenia refers to a condition where the absolute count of white blood cells in peripheral blood persistently falls below 4.0×10^9/L, commonly known as leukopenia. There are many causes of leukopenia, which can generally be divided into two categories: defects in white blood cell production, and excessive destruction or consumption. Common causes include certain chemicals, radiation, cytotoxic drugs, some hematological diseases such as aplastic anemia and myelodysplastic syndrome, as well as Vitamin B12 deficiency, and drugs used to treat hyperthyroidism. Additionally, viral infections can lead to excessive white blood cell consumption and result in leukopenia. Therefore, when leukopenia occurs, it is crucial to actively search for the underlying causes and treat the primary condition. Meanwhile, if the patient's white blood cell count is significantly reduced, drugs that increase white blood cells may be temporarily administered to elevate the patient's white blood cell count.