Is a drop in leukocytes in the blood a sign of a decline in immunity?
Is a decrease in leukocytes in the blood a sign of a decrease in immunity, or can it mean more serious ailments and what?
Leukocytes (white blood cells, WBC) are a heterogeneous population of cells. The total number of peripheral blood leukocytes is 4000-10000 / ml. Thanks to modern analyzers serving, among others, for the assessment of peripheral blood counts, not only can the number of white blood cells in a given blood volume be determined, but also divide them into 3 or 5 subpopulations. These include granulocytes (neutrophilic, eosinophilic, and basophilic), lymphocytes, and monocytes. The results of the analysis are presented as absolute values, percentage formula and graphically as histograms (according to the National Communite for Clinical Laboratory Standards NCCLS, the percentage formula serves only the diagnosis of some qualitative disorders and not quantitative leukocyte subpopulations).
It is very important to interpret changes in the total number of leukocytes together with changes in the number of their subpopulations. At the same time, the decrease in the total number of leukocytes is mainly the result of changes in the most abundant subpopulations – neutrophils and lymphocytes. The most common cause of neutropenia, i.e. a decrease in the number of neutrophils below 1500 / ml (agranulocytosis <500 / ml) is their reduced production, excessive destruction and their excessive shift to the so-called marginal zone, which may occur among patients undergoing dialysis, operated "in extracorporeal circulation" or with generalized infections mainly of bacterial etiology. The first two causes of neutropenia are related to treatment (mainly cytostatic drugs, antibiotics, thyreostatic drugs, antipsychotics or anticonvulsants), hematological diseases (aplastic anemia, myelodysplastic syndromes, osteomyelofibrosis, leukemias), nutritional deficiencies (vitamin B deficiency12deficiency of folic acid common among alcoholics), infections (mainly viral and tuberculosis) and autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, Felty’s syndrome). Susceptibility to infection increases significantly if the neutrophil count drops below 1000 / ml. Therapeutic management should depend on the patient’s general condition, degree of neutropenia and its cause, and should be performed in a hospital setting.
Lymphopenia is the reduction of the absolute number of lymphocytes below 1500 / ml. It most often occurs in the course of primary and secondary immune deficiencies (e.g. HIV), neoplastic diseases (Hodgkin’s disease), acute infectious diseases (sepsis), after cytostatic treatment and radiotherapy, in circulatory failure and in the course of treatment with glucocorticoids. It is significant that a long-term decline in lymphocytes below 500 / ml is an independent risk factor for the development of opportunistic infections and the incidence of certain neoplastic diseases, such as non-Hodgkin’s lymphoma, Kaposi’s sarcoma.
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