lymphopenia
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Introduction
Defined as a total lymphocyte count of < 1000/uL.
Most patients with lymphopenia have a reduction in T-cells, & CD4+ T-cells (helper cells) in particular.
Etiology
- inherited causes
- congenital immunodeficiency disorders
- severe-combined immunodeficiency disease
- aplasia of lymphopoietic stem cells
- adenosine deaminase deficiency
- absence of histocompatibility antigens
- absence of CD4+ helper cells
- thymic alymphoplasia with aleukocytosis (reticular dysgenesis)
- ataxia telangiectasia
- Wiskott-Aldrich syndrome
- immunodeficiency with short-limbed dwarfism (cartilage hair hypoplasia)
- immunodeficiency with thymoma
- cellular immunodeficiency with immunoglobulins
- purine nucleoside phosphorylase deficiency
- immune deficiency with venooclusive disease of the liver
- severe-combined immunodeficiency disease
- idiopathic
- CD4+ T-lymphocytopenia
- congenital immunodeficiency disorders
- acquired causes
- aplastic anemia
- infectious diseases
- iatrogenic
- immunosuppressive agents
- anti-lymphocyte globulin therapy
- glucocorticoids
- high-dose PUVA treatment
- cancer chemotherapy
- platelet apheresis
- radiation
- surgery
- thoracic duct drainage
- immunosuppressive agents
- in association with systemic diseases
- nutritional
- older adults have lower lymphocyte counts than younger patients
Management
- lymphopenia without clinical consequences of associated disease does not require treatment[2]