If the doctor finds too few leukocytes in the blood count , this is referred to as leukopenia .
The white blood cells are at the front of the immune system , fighting pathogens and mediating inflammatory reactions. If there are too few leukocytes in the blood, one suffers more from infections . Below we explain everything you need to know about the lack of leukocytes in the blood.
Too few leukocytes: What do leukocytes actually do?
The blood value of the leukocytes, LEUK or WBC for white blood cells , is an important part of the small blood count . Because it provides information about the functionality of the immune system .
Some of the white blood cells take care of invading bacteria, viruses and protozoa ( cellular immune defense ), others render them harmless with antibodies ( humoral immune defense ).
Therefore, too few leukocytes in the blood lead to a deterioration in the immune status . Patients suffer more quickly from infections, which also last longer than usual. Such a condition with a reduced number of leukocytes is medically referred to as leukocytopenia , or leukopenia for short .
Too few leukocytes – the most important things at a glance!
- Leukocytes or white blood cells are the cells of the immune system that eliminate invading pathogens. Therefore, too few leukocytes in the blood are particularly noticeable in an increased susceptibility to infections.
- The count of leukocytes in the blood is part of the small blood count; in the complete blood count, a distinction is also made between the different types of white blood cells.
- There are too few leukocytes in the blood if large amounts of them are used up and not reproduced quickly enough. This is particularly the case with infections and autoimmune diseases.
- Impaired formation of white blood cells also leads to leukopenia. This is mostly due to damage to the blood-forming system in the bone marrow.
- Blood cancer ( leukemia ) can cause the number of functioning white blood cells in the blood to drop rapidly and be replaced by non-functioning cancer cells.
Too few leukocytes: Underlying diseases cause secondary diseases
A whole range of diseases , but also various medications, cause too few leukocytes in the small blood count.
The impaired immune defense means that they are not left alone and that the weakened immune system leads to further diseases . These include primarily infections .
In the most harmless case there is an increased susceptibility to infection , in the worst case actually harmless infections can be fatal if the immune system fails completely .
Too few leukocytes: table
In the table below you will find the normal ranges for the different types of leukocytes as well as the limits for too much and too little white blood cells.
| white blood cells in the blood count |
clinical description/cell type | Number of leukocytes in the blood |
|
| normal | Total reference range for leukocyte blood counts (LEUK, WBC). | 3.800 – 10.500/µl | |
| lymphocytes | 25 – 45 % | ||
| total granulocytes | 58 – 72 % | ||
| total neutrophilic granulocytes▪ | 57 – 67 % | ||
| rod neutrophilic granulocytes▪▪ | 3 – 5 % | ||
| segmented neutrophilic granulocytes▪▪ | 54 – 62 % | ||
| eosinophilic granulocytes▪ | 1 – 4 % | ||
| basophilic granulocytes▪ | 0 – 1 % | ||
| monocytes | 3 – 8 % | ||
| too few leukocytes | Leukopenia (leukocytopenia) | < 3.500/µl | |
| critical leukopenia | < 800/µl | ||
| too many leukocytes | leukocytosis | > 10.500/µl | |
Of clinical interest and important for laboratory medicine, in addition to leukopenia as a reduction in all counted white blood cells, are the reductions in lymphocytes ( lymphopenia ) and granulocytes ( granulocytopenia ).
Neutropenia , a reduced number of neutrophilic granulocytes, which make up the majority of granulocytes , plays a particularly important role here .
Reduced amounts of eosinophilic and basophilic granulocytes or monocytes also occur, but play no role in the diagnosis. In any case, their normal proportion of the total number of white blood cells is less important than the number of lymphocytes and neutrophilic granulocytes.
| description in the blood count | clinical designation | clinical relevance |
| too few leukocytes in total | leukopenia, leukocytopenia | hoch |
| too few lymphocytes | Lymphozytopenie (Lymphopenie) | hoch |
| too few granulocytes | Granulocytopenias | hoch |
| too few neutrophils▪ | Neutropenia, Neutrocytopenia | hoch |
| too few eosinophilic granulocytes▪ | Eosinopenie, Eosinozytopenie | irrelevant |
| too few basophilic granulocytes▪ | Basopenia, Basotopenia | irrelevant |
| too few monocytes | Monozytopenias | irrelevant |
Too few leukocytes and which diseases lead to leukopenia?
Leukopenia occurs when
- Infections “consume” white blood cells
- they cannot be reproduced quickly enough by autoimmune diseases,
- the spleen, which keeps blood cells in reserve, withdraws them from the bloodstream,
- the blood-forming bone marrow is damaged,
- Drugs that affect blood formation
- substances necessary for their formation are missing,
- or blood cancer prevents the formation of mature white blood cells.
Overview of the diseases
Apart from the side effects of some medications, the following diseases are responsible for a reduction in the number of leukocytes in the blood count.
Increased use of white blood cells by infections. The immune system fights bacteria, viruses and protozoa primarily with cells that attack the invaders and render them harmless. During this use of hara-kiri, the cells themselves perish and their remains as well as the aggregates of immune cells, pathogens and antibodies are eliminated by scavenger cells . As a result, infections deprive the blood of leukocytes. These infections causing leukopenia include
- Bacterial Infections
- Typhus
- Lyme-Borreliose
- Brucellosis
- Psittakose
- Brucellosis
- Infections with viruses
- Influenza and influenza infections
- measles
- Mumps
- rubella
- Protozoan infections
- Malaria
- Typhus
Deprivation of white blood cells by autoimmune diseases. In autoimmune diseases, the immune system mistakenly attacks endogenous substances. In principle, the immune system reacts to a false alarm in a similar way to an infection, with comparable effects on the blood’s white blood cell content.
- allergies
- hay fever
- Dust mite allergy
- animal dander allergies
- Hashimoto’s thyroiditis with destruction of the thyroid gland
- Sjögren’s syndrome with destruction of the salivary and lacrimal glands
- rheumatic fever and
- Rheumatoid arthritis caused by cross-reaction of antibodies against streptococci with endogenous structures
- Collagen diseases, diseases of the connective tissue
- systemic lupus erythematosus
- scleroderma
- Polymyositis
Dermatomyositis - scleroderma
- Sharp Syndrome
- CREST-Syndrom
Morbid changes in the spleen. The spleen is an important organ for storing red and white blood cells.
If necessary, they are released so that they can carry out their tasks in the periphery. When the spleen becomes abnormally enlarged, for example as a result of alcohol abuse, this is referred to as hypersplenism and splenomegaly.
Red and white blood cells collect in the organ, which is severely swollen in this way, and are thus withdrawn from the blood. The consequences are anemia (due to a lack of red blood cells) and leucopenia (due to a lack of white blood cells).
Damage to the blood-forming bone marrow. In adults, red and white blood cells are formed in the blood-forming system of the bone marrow, for example in the marrow of the large tubular bones or the pelvic bones.
Since there is always a need for blood cells , the bone marrow is one of the cells in the body that has the highest rate of division. This makes them particularly sensitive to all chemical and physical influences that damage DNA.
These primarily include ionizing radiation in the form of radioactivity and radiation, as used in cancer therapy.
Another important component of many cancer treatments is chemotherapy with cytostatics that prevent cell division. Tumor cells are characterized by rapid growth. Radiation and chemotherapy take advantage of this and attack such fast-growing cells.
The catch: This includes not only the tumor cells, but also the cells of the bone marrow, as well as the epithelial cells of the skin and mucous membranes or hair roots.
Deficiency symptoms in blood formation. For the formation of white blood cells, the bone marrow needs vitamin B12, folic acid, copper and zinc, among other things. If there is a lack of these substances due to insufficient intake or insufficient intake from food, leukopenia occurs.
Blood cancer overgrowth. In leukemia, abnormal cells in the bone marrow begin to proliferate, forming numerous immature cells that cannot take over the function of normal blood cells.
This leads to the paradoxical phenomenon that the blood is full of (non-functional) white blood cells, but leukopenia (of functioning leukocytes) prevails. Here, too, the immune system suffers, since the mass-produced precursors are not able to fulfill their tasks.
Sources, links and further reading
- Willibald Pschyrembel: Clinical Dictionary. 266th edition. Berlin 2014: Walter de Gruyter-Verlag. ISBN-10: 3110339978.
- Reinhard Andreesen, Hermann Heimpel: Clinical hematology. Munich 2009: Urban & Fischer/Elsevier-Verlag. ISBN-10: 343731498X.
- Marlies Michl: BASICS Hematology. Munich 2016: Urban & Fischer/Elsevier-Verlag. ISBN-10: 3437421697.
- Helga Donath: Internal medicine. Textbook for Nursing and Studies. 7th edition. Stuttgart 1993: Schattauer-Verlag. ISBN-10: 3794514963.
- Wolfgang Piper: Internal medicine. 2nd Edition. Stuttgart 2012: Springer Verlag. ISBN-10: 3642331076.
- Gerd Herold: Internal Medicine. Cologne 2016: G. Herold-Verlag. ISBN-10: 3981466063
