lymphopenia
Introduction
Introduction to lymphopenia Lymphopenia refers to the total number of lymphocytes in adults <1000/l, and children (under 2 years) <3000/l. The normal adult lymphocyte count is 1000~4800/l, the child (under 2 years old) is 3000~9500/l, and the 6 year old reaches the normal low value of 1500/l. About 65% of peripheral blood T cells are CD4+ (helper) T cells. The absolute number of T cells is reduced in most patients with lymphopenia, especially in the number of CD4+ cells. The average CD4+ T cells in adult peripheral blood were 1100/l (300~1300/l), and the absolute number of CD8+ (inhibitory) T cells in other major T cell subsets was 600/l (100~900/l). basic knowledge The proportion of illness: the incidence rate is around 15% Susceptible people: common in women Mode of infection: non-infectious Complications: rubella varicella pneumonia
Cause
Causes of lymphopenia
Hereditary lymphopenia (30%):
It may be associated with hereditary immunodeficiency disease, which causes lymphoid ineffective hematopoiesis due to abnormalities in the quality and quantity of stem cells. Other causes, such as Wiskott-Aldrich syndrome, can be caused by accelerated destruction of T cells. Patients with adenosine deaminase deficiency and purine nucleotide phosphorylase deficiency develop the same mechanism as described above.
Acquired lymphopenia (30%):
It is a syndrome with loss of peripheral blood lymphocytes that is not secondary to hereditary diseases. ADIS is the most common infectious disease with lymphopenia caused by the destruction of HIV-infected CD4+ T cells. Other viral or bacterial diseases can also be associated with lymphopenia. In some cases of acute viremia, lymphocytes may be accelerated by viral activation, or may be trapped in the spleen or lymph nodes or migrate to the respiratory tract.
Iatrogenic lymphopenia (20%):
May be caused by cytotoxic chemotherapy, radiotherapy and injection of lymphocyte globulin. Long-term use of psoralen and ultrasound radiation in patients with psoriasis can damage T cells. Glucocorticoids cause lymphopenia by inducing cell damage.
Other factors (5%):
Lymphopenia can occur in autoimmune-related systemic diseases such as SLE, rheumatoid arthritis, and myasthenia gravis. Loss of protein enteropathy can be accompanied by a decrease in lymphocytes.
Prevention
Lymphopenia prevention
The disease has not been determined due to the etiology, may have a certain correlation with environmental factors, genetic factors, dietary factors and mood, nutrition, etc. during pregnancy, so this disease can not be directly prevented. Early detection, early diagnosis, and early treatment are important for preventing this disease. Regular examination should be done during pregnancy. If the child has a tendency to develop abnormalities, chromosome screening should be done in time, and abortion should be performed in time to avoid the birth of the diseased child.
Complication
Lymphopenia complications Complications Rubella varicella pneumonia
Complications: An unusual response to a benign infectious agent or a rare pathogen infection may occur. The occurrence of Pneumocystis carinii, cytomegalovirus, rubella or varicella pneumonia suggests the possibility of immunodeficiency. Any type 1 pneumonia caused by the above infection can be fatal.
Symptom
Symptoms of lymphopenia Common symptoms Repeated infection Immunodeficiency Jaundice Oral ulcers Spleen large cells Reduce eczema lymphadenopathy
Lymphopenia does not cause symptoms in general and is usually found in the diagnosis of other diseases, especially in cases of recurrent viral, fungal or protozoal infections. Lymphocyte counts determine lymphopenia. Lymphocyte subsets can be determined by multiparameter flow cytometry, which uses antigenic expression for cell sorting and characterization.
Repeated infections in patients with lymphopenia often result in unusual reactions to benign infectious agents in general or with rare pathogen infections. The occurrence of Pneumocystis carinii, cytomegalovirus, rubella or varicella pneumonia suggests the possibility of immunodeficiency. Any type 1 pneumonia caused by the above infection can be fatal. Patients with this disease have a higher incidence of cancer or autoimmune diseases. The patient's tonsils or lymph nodes disappear or shrink, indicating a cellular immune deficiency. Abnormal skin such as hair loss, eczema, pyoderma or telangiectasia; bloodline lesions showing pale, purpura, jaundice or mouth ulcers; and systemic lymphadenopathy and splenomegaly. These signs may suggest HIV disease.
Examine
Examination of lymphopenia
Laboratory tests: Blood tests and immunological tests can be diagnosed. Multi-parameter flow cytometry can determine lymphocyte subsets. The assay uses antigenic expression for cell sorting and characterization.
Diagnosis
Diagnosis and diagnosis of lymphopenia
Since 80% of patients with primary immunodeficiency also have antibody deficiency, antibody function tests and immunoglobulin levels are appropriate. Patients with a history of repeated infections should be examined for immunodeficiency even if the initial screening test results are normal. Extremely low neutrophil counts may indicate severe congenital neutropenia, periodic neutropenia, severe chronic neutropenia, bone marrow failure, and bone marrow replaced by tumors or other hematopoietic cells. And other diseases. The understanding of the clinical features of immunodeficiency disease will explain the results of the laboratory tests more reasonably.
The disease can be diagnosed according to laboratory tests and does not need to be differentiated from other diseases.
