Leukopenia - Symptoms, Causes, Diagnosis, Treatment
What is Leukopenia?
Leukopenia is a medical condition wherein there is a decrease in the number of circulating white blood cells (WBCs). In leucopenia, usually the number of circulating white blood cells falls below 4,000. There can be several reasons for this which includes viral infections and cancers involving the bone marrow. Leukopenia can also be brought about by chemotherapy. The typical manifestation of leukopenia is gingivitis or periodontitis. When you frequently experience this you might be suffering from leukopenia. This can be a potentially dangerous condition especially when not given prompt medical attention. Extremely low levels of white blood cells increase your risk of acquiring opportunistic infections. Usually when you have leukopenia, you will also have neutropenia. This is its initial manifestation.
Only with extremely low levels of white blood cells that symptoms may likely manifest. Initially, the patient may have neutropenia or low neutrophil count. It is important to consider the neutrophil count since this is the most abundant type of white blood cell and is an indicator of an existing infection. The following are the symptoms which may likely show up when the number of white blood cells drops down greatly:
- Anemia - Along with the decline in WBCs (white blood cells), anemia may also occur. This can be defined as a low level of hemoglobin or red blood cells (RBCs). This can be due to blood dyscrasias. Red blood cells are needed for the proper circulation of oxygen in the body.
- Fatigue - Since there is also a low hemoglobin level in leukopenia, one may also have increased fatigability even with slight exertion. This is amongst the common manifestations of leukopenia.
- Fever - Due to the low levels of circulating WBCs, a person is at high risk of developing opportunistic infections. Fever is an indication that a person has an ongoing infectious process.
- Headache - This may also manifest due to the decrease hemoglobin levels. Poor oxygenation to the brain may result to headaches and changes in the level of consciousness.
- Liver Abscess - In severe cases of leukopenia, there may be formation of liver abscesses brought about by a bacterial infection. This is usually a rare case but is considered one of the most fatal when it occurs.
- Menorrhagia - There can also be abnormal menstrual periods as manifested by heavy bleeding and prolonged duration.
- Metrorrhagia - Bleeding originating from the uterus may also take place. However, this cannot be accounted from a menstrual period but from an existing infection.
- Neurasthenia - This is a cluster of symptoms which include disturbed emotional balance, fatigue and headache. A person with leukopenia may also likely experience this.
- Pneumonia - When the infection has already gained access to the system this may likely affect the lungs. These could get clogged up with virus and bacteria which likely results to pneumonia. This condition also requires immediate medical treatment so as to avoid complications.
- Stomatitis - This can be brought about by some infections. Stomatitis appears as an inflammation usually of the mucous lining of the mouth and may likely include the lips, gums, tongue and cheeks.
- Thrombocytopenia - Also brought about by blood dyscrasias, thrombocytopenia may also manifest along with leukopenia. Thrombocytopenia can be defined as a decrease in the number of platelets or thrombocytes. These are the blood components which are responsible for the clotting mechanism of the blood.
- An individual suffering from leukopenia may have existing different infections and may likely manifest mouth ulcers.
- You may also find them craving for hot drinks.
There can be several sited reasons for the occurrence of leukopenia. However, this can be generally due to excessive use of neutrophils or it can also be that the body is not producing enough neutrophils. The following are the presupposed causes of leukopenia.
- Aplastic anemia
- Certain types of cancer
- Dengue Fever
- Hodgkin’s lymphoma
- Folate deficiencies
- Rickettsial Infections
- Splenomegaly ( Enlarged spleen)
- Zinc and Copper deficiencies.
When diagnosing an individual for leukopenia, it is imperative to consider the patient’s history. He or she may have undergone chemotherapy in the past or may have been exposed to certain types of radiation. However, the following laboratory workups are usually done:
- Platelet count
- Sedimentation Rate
- Differential count
- Chemistry panel
- Febrile Agglutinins
- Serum protein electrophoresis
- B12 and Folate Deficiencies
When the above mentioned tests are already done, the next procedures carried out are bone marrow examinations and hematology consultation. The following other tests may also be useful in diagnosing leukopenia:
- Bone scan for metastatic neoplasm
- CT scan to detect splenomegaly, liver disease and neoplasm
- Donath–Landsteiner test (paroxysmal cold hemoglobinuria)
- Liver and spleen scan
- Lymph node biopsy for Hodgkin’s disease and presence of metastasis
- Skeletal survey if there’s any metastatic neoplasm.
The treatment for leukopenia is usually palliative. It is targeted to alleviate the different symptoms. The treatment is also specific to the cause of the leukopenia. However, it is commonly managed through the following:
- Vitamins and steroids - In order to help increase the levels of white blood cells, these are usually given to patients. These are helpful in activating the bone marrow to produce more WBCs.
- Chemo and Cytokine therapies - These may also be prescribed by physicians especially when the cause of leukopenia is due to some forms of cancer
- Drug Cocktail - There’s also a chance that the patient needs to have drug cocktail to make the treatment more effective but this depends on certain instances.