Leukopenia – Causes, Complaints & Therapy

In medicine, leukopenia describes a reduced number of white blood cells (also known as leukocytes) in the blood of an affected person. Since the human organism has different types of white blood cells, leukopenia can also take different forms in individuals:

While granulopenia affects the granulocytes, a reduced number of lymphocytes is a so-called lymphocytopenia. Leukopenia stands in contrast to leukocytosis, which describes an increased incidence of white blood cells.

Causes

Possible causes of leukopenia depend, among other things, on the form of the disease that occurs. First of all, leukopenia often occurs in the presence of an infectious disease – here leukopenia is usually the result of an increased need for white blood cells.Various blood diseases such as sepsis (blood poisoning), forms of anemia (anemia) or leukemia (blood cancer) can also cause leukopenia. If leukopenia occurs as a result of bone marrow diseases, the cause is often a limited formation of new white blood cells.

In addition, certain medications can cause leukopenia – for example, a reduction in white blood cells is often accompanied by chemotherapy (a drug treatment for various cancers).

In addition, so-called neuroleptics (drugs that have, among other things, a calming effect) or drugs for the treatment of chronic inflammatory diseases (such as the intestinal disease Crohn’s disease) can lead to leukopenia. Not in all cases of drug-induced leukopenia, an active ingredient used suggests a decrease in white blood cells in advance.

Symptoms and course

In most cases, leukopenia does not lead to noticeable symptoms. Depending on the individual severity of a lack of white blood cells, however, patients suffering from leukopenia show an increased susceptibility to infections – such an increased risk of infection exists above all with regard to diseases caused by bacteria.

The individual course of leukopenia and the associated problem depends, among other things, on the cause of the reduced number of white blood cells – if a corresponding cause can be successfully countered, this usually also has a positive effect on the course of the disease. Depending on the cause of leukopenia and the associated treatment options, leukocyte deficiency can take an acute (temporary) or chronic (long- to long-term) course.

Diagnosis

Since leukopenia is usually hardly associated with specific symptoms, a diagnosis of the disease is often made with a time delay and/or accidentally. A suspicion of leukopenia (for example, due to the occurrence of frequent infections or the use of certain medications) can be checked by determining the number of white blood cells. This is done by means of a laboratory examination of the blood sample of an affected person. Leukopenia is diagnosed in medicine when the number of leukocytes per microliter of blood has fallen below about 4,000. Depending on the remaining amount of leukocytes, a distinction is made between mild, moderate and severe leukopenia.

Complications

Leukopenia manifests itself through various complaints and can cause a variety of complications. In mild cases, a low proportion of white blood cells is unproblematic and disappears on its own after a few days. Complications can be expected only if the imbalance persists for a long period of time or if there is a severe deficiency of leukocytes. First and foremost, leukopenia then leads to an increased susceptibility to infections. This leads to increased colds, flu and other serious bacterial diseases, which are accompanied by a number of other complications.

In addition, wound healing is delayed and the quality of life in general is significantly reduced. In the late stages, various inflammations occur. In the absence or insufficient treatment, the death of the patient may occur. With drug treatment with antibiotics, there are the usual risks and side effects. Allergy sufferers, children, the elderly and people with a chronic illness are particularly at risk. Leukopenia can recur after surviving the disease.

treatment and therapy

An individually suitable therapy for leukopenia depends, among other things, on the severity and cause of the disease. Mild leukopenia can often be treated by outpatient treatment with antibiotics. Whether this treatment method is also sufficient for a moderate form of leukopenia must be weighed up by the responsible specialists in the specific case. Severely pronounced leucopenia (such as when lymphocytopenia and granulopenia are present at the same time) usually require inpatient medical treatment.

If the leukocytes are reduced, for example due to an HIV infection, special medicinal growth factors can lead to an increase in the white blood cells. In the case of leukopenia caused by other factors, however, such drug treatment often does not contribute to the desired therapeutic success.

The usefulness of a rarely performed transfusion of granulocytes in leukopenia in the form of granulopenia is controversial in medicine due to the short lifespan of these white blood cells. Inpatient treatment concepts for severe leukopenia include, for example, what is known as reverse isolation – for this purpose the affected patient is in an isolation ward.

Reverse isolation is intended to prevent a person suffering from leukopenia from coming into contact with germs that can lead to infectious diseases. As part of therapy in the isolation ward, strict regulations must be observed by staff and visitors – for example, contact with the patient only takes place on the way through a special lock.

Prevention

Due to the diverse causes that can be hidden behind leukopenia, the disease can only be prevented to a limited extent. For example, if a person has a known susceptibility to infectious diseases, early visits to the doctor can help fight infection and reduce the risk of leukopenia. If there is an increased susceptibility to infection as a result of certain medications, a change in medication can counteract the leukopenia (provided it is medically advisable).