Many patients get routine blood tests and find that the white blood cell reduction, this is very nervous, do not know what to do, nervous about whether they have a blood disease, now to clarify to the majority of patients, caused by the white blood cell reduction of many causes, not all for the blood disease, the next will explain to patients the causes of white blood cell reduction and diagnosis and treatment.
The white blood cells in the blood mainly consist of granulocytes, lymphocytes and monocytes. When we talk about a decrease, we are referring to a decrease in granulocytes. When bacteria and other foreign substances invade the body, leukocytes enter the invaded area and surround, engulf and destroy the bacteria. Therefore, leukopenia weakens the body’s antimicrobial capacity, reducing the body’s immunity and making it vulnerable to infection. Because the clinical symptoms of leukopenia are mainly having recurrent infections, in addition to non-specific manifestations such as dizziness, fatigue, and fever. A normal value of leukocytes (4-10) × 109/L and leukocytes < 4 × 109/L are diagnosed as leukopenia. Not all leukopenia requires interventional therapy. Only a mild decrease or a transient decrease that does not continue to fall at the time of reexamination and with no uncomfortable symptoms is not necessary to stress or treat, and dynamic monitoring of blood count is sufficient. If there is a significant decrease in leukocytes, because the patient's body resistance is basically or completely lost, bacteria can easily invade the body and even enter the bloodstream to cause sepsis, which can be life-threatening in serious cases. Therefore, a significant decrease in leukocytes requires attention, and if there is a cause for leukocytopenia, the cause should be addressed and treated. The common causes of leukopenia are analyzed as follows: 1, hereditary, periodic, familial, pseudo-leukopenia (mainly neutrophils): these three are collectively called benign leukopenia (mainly neutrophils), such patients have no primary disease and no recurrent infection symptoms, no intervention is required, and can resolve on their own. 2, drug-induced leukopenia: taking “antipyretic and analgesic drugs, sulfonamides, anti-rheumatic drugs, anticonvulsant drugs, antithyroid drugs, hypoglycemic drugs, chemotherapy drugs” can appear leukocyte (mainly neutrophils) reduction, if there is a significant reduction in leukocytes, the drug needs to reduce, stop or change the drug, generally Leukocytes can return to normal after stopping the drug. 3, leukopenia due to nutritional deficiency: these patients coexist with nutritional megaloblastic anemia, giving supplemental folic acid, vitamin B12 can achieve better results. 4, leukopenia due to viral infections: Influenza virus, hepatitis virus, HIV virus and other infections can cause leukopenia. Such patients should be actively treated with antiviral therapy on the one hand, and on the other hand, leukocyte-raising drugs can be added as appropriate. 5, immune diseases caused by leukopenia: patients with autoimmune system diseases (such as rheumatoid, dry syndrome, systemic lupus erythematosus) can also appear leukopenia. Such patients should be treated for the primary disease, and leukocyte-raising drugs can be added on top of the treatment of the primary disease. 6. Hypersplenism: When hypersplenism is caused by splenomegaly, a large number of blood cells (red blood cells, white blood cells) and platelets are blocked in the spleen and are destroyed and phagocytosed, so hypersplenism often causes a decrease in the three series (white blood cells, red blood cells and platelets). Splenectomy may have a better outcome for such patients. 7. Leukopenia due to hematologic disease: For leukopenia combined with a decrease in red blood cells (or hemoglobin) and platelets, especially a significant decrease in hematologic disease (e.g., myelodysplastic syndrome, acute leukemia, myelofibrosis), such patients are recommended to have bone marrow morphology, bone marrow biopsy, genetic and immunophenotyping and chromosomal examination to clarify the presence of hematologic disease and to target the type of hematologic disease Timely treatment.