Leukopenia
Introduction
Introduction to leukopenia The number of white blood cells in the blood varies widely. When there are more than 10,000 per microliter, it is called leukocytosis, and when it is less than 4000 per microliter, it is called leukopenia. When the body has inflammation (ie inflammation), it will appear leukocytosis; leukopenia may be hereditary, Familial, acquired, etc. Among them, gain is the majority. Drugs, radiation, infections, toxins, etc. can all reduce granulocytes, and drugs are most common. Avoid medication to avoid leukopenia caused by the drug. Generally, patients with mild reduction do not have special symptoms in clinical practice, and most of them manifest as primary symptoms. Moderate and severe reductions are prone to infections and non-specific symptoms such as fatigue, weakness, dizziness, and loss of appetite. Contact with suspected drugs or other pathogenic factors should be stopped immediately. Secondary reduction should actively treat the primary disease, acute leukemia, autoimmune diseases, infections, etc. After treatment or remission or control, granulocytes can return to normal. Splenectomy may be considered in patients with hypersplenism. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: neutropenia
Cause
Causes of leukopenia
Congenital factors (45%)
Leukopenia, including a decrease in proliferation or aplastic disorder by stem cells. Due to the abnormal distribution of granulocytes, the number of white blood cells in the marginal pool is increased, and the white blood cells in the circulation pool are reduced, and leukopenia is also formed.
Disease factor (45%)
The day after tomorrow, due to disease, excessive destruction of white blood cells, especially a variety of drugs and autoimmune diseases caused by immune and various infections caused excessive consumption, so that peripheral blood leukocytes decreased. Granulocytes attach to the vessel wall and move to the spleen causing abnormal distribution, such as various allergies and endotoxemia.
Prevention
Leukopenia prevention
It is related to the etiology and extent, duration, progression, and treatment of neutropenia. Light, moderate, if not progress, the prognosis is better. Patients with agranulocytosis have a higher mortality rate, and the prognosis depends on whether the cause can be removed in time, the infection is controlled, and the number of neutrophils is restored.
Those exposed to radioactive chemistry and chemical poisons such as benzene and those who are prone to cause neutropenia should be regularly checked for blood routine and treated at the same time. Patients with a history of drug allergy or granulocytopenia after treatment should avoid taking similar drugs.
Complication
Leukopenia complications Complications, neutropenia
It usually appears as a symptom of other diseases.
Symptom
Symptoms of Leukopenia Common Symptoms Leaning Leukocytes Reduces Septic Thrombosis Dizziness, Pneumocytosis, Abscess, Abscess, High Heat Loss of Appetite
The clinical manifestations of this disease vary with the cause, extent and duration of leukopenia or neutropenia. According to the degree of neutropenia, it can be divided into mild 1.0×10^9/L, moderate (0.5~1.0)×10^9/L and severe<0.5×10^9/L. For granulocytosis.
Generally, patients with mild reduction do not have special symptoms in clinical practice, and most of them manifest as primary symptoms. Moderate and severe reductions are prone to infections and non-specific symptoms such as fatigue, weakness, dizziness, and loss of appetite. Common infection sites are the respiratory tract, digestive tract and genitourinary tract. High-heat, mucosal necrotizing ulcers and severe sepsis, sepsis or septic shock can occur. When the granulocytes are severely deficient, the infected site can not form an effective inflammatory reaction, often without pus, X-ray examination can be no inflammatory infiltrating shadow or not obvious, abscess puncture can be no or a small amount of pus.
Examine
Leukopenia examination
1, blood routine: leukopenia, neutrophils decreased, the percentage of lymphocytes increased.
2, bone marrow smear: different causes of neutropenia, bone marrow is different.
3, blood: red blood cells and platelet counts are normal, some malignant tumors infiltrating the bone marrow, accidental acute radiation accidents can be accompanied by anemia and thrombocytopenia.
4, bone marrow.
5. Bone marrow biopsy.
6, bone marrow culture.
7. Anti-neutrophil antibody assays help identify if there is a reduction in immune neutropenia.
8, anti-nuclear antibody (ANA), rheumatoid factor (RF) titer determination, immunoglobulin determination.
Diagnosis
Diagnosis of leukopenia
Medical history
Pay attention to the speed, duration and periodicity of neutropenia, the history of exposure to drugs, poisons or radiation. Whether there are acute and chronic infections, rheumatoid arthritis and other connective tissue diseases. Whether there is a family history.
Medical examination
There are no positive signs and infections of lymph nodes, hepatosplenomegaly, sternal tenderness and related diseases.
Laboratory inspection
(1) Blood routine observation of the degree of neutropenia and whether it is accompanied by other systemic cell reduction and abnormal cells. For those suspected of periodic neutropenia, adults should check the blood for 2 times a week for 6 to 9 weeks; the child should check the blood for 1 time every week for 4 weeks.
(B) the bone marrow to observe the degree of proliferation, the proportion of various stages of the granule and other cell lines, can provide clues for the diagnosis of primary disease or the cause of neutropenia. In autoimmune diseases secondary to neutropenia, the granulocyte is shifted to the left and the early cells are compensatory. Leukemia, metastases and other abnormal cell infiltration can be seen. Poisoning, drugs and severe infections caused by agranulocytosis, granulocyte nucleus pyknosis, cytoplasmic toxic particles, vacuoles increased. Myeloid hyperplasia is suppressed in patients with aplastic anemia, and the three lines are reduced.
(3) Special inspection
1. Adrenaline test Adrenalin causes marginal pool neutrophils to enter the circulation pool. Thereby identifying pseudogranulocyte reduction.
2. Neutrophil-specific antibody assays include leukocyte aggregation reactions, immunofluorescent granulocyte antibody assays to determine the presence of anti-granulocyte autoantibodies.
