What does a low Lymphocyte count mean?
A low lymphocyte count is known as Lymphocytopenia (or lymphopenia) and it occurs when the lymphocyte count in your blood is lower than usual (below the laboratories reference ranges).
Severe and chronic low counts:
Severe or chronic low counts can indicate a possible infection or other illness and should be investigated by your doctor.
Low levels of T cells or too few NK cells can lead to uncontrolled viral, fungal, and parasitic infections. B-cell lymphocytopenia can lead to an increase in harmful and different types of infections.
What causes a low Lymphocyte count?
Lymphocytopenia (or lymphopenia) may be a sign of an underlying illness, condition, or another factor. Causes are usually acquired, which means that you develop rather than inherit them.
Autoimmune disorders:
Autoimmune disorders occur if the immune system is in overdrive and incorrectly attacks the body’s cells and tissues.
These can include: lupus, myasthenia gravis, rheumatoid arthritis.
Certain immunosuppressant medications used to treat autoimmune disorders may cause lymphocytopenia.
Cancer and treatments for cancer:
Lymphoma (such as Hodgkin’s lymphoma), Kaposi sarcoma, and leukemia are among the most common cancers that can cause low lymphocyte levels.
The following cancer treatments may also result in lymphocytopenia:
- chemotherapy
- radiation therapy
Diseases that affect the blood and bone marrow:
These conditions can cause low lymphocyte levels:
- aplastic anemia
- lymphoproliferative disorders
Infections:
Viral, bacterial, parasitic, and fungal infections are common causes of lymphocytopenia. Any type of infection may cause your lymphocyte count to fall. For example:
- HIV
- histoplasmosis
- influenza
- malaria
- viral hepatitis
- tuberculosis
- typhoid fever
Sepsis:
Lymphocytopenia may be a sign of sepsis or acute bacteremia.
Inherited causes:
Inherited or congenital causes of lymphocytopenia are rare. Some of these are:
- ataxia-telangiectasia
- DiGeorge syndrome
- severe combined immunodeficiency
- Wiskott-Aldrich syndrome
Nutritional causes:
Malnutrition or undernutrition is a common global cause of lymphocytopenia. This occurs when the body lacks protein and other nutrients necessary to produce lymphocytes.
An eating disorder, such as anorexia nervosa, may lead to reduced-production lymphocytopenia.
Gastrointestinal conditions:
Conditions that damage the gut wall can affect the body’s absorption of nutrients and may lead to lymphocytopenia in some cases. These are generally referred to as protein-losing enteropathy and include:
- amyloidosis
- celiac disease
- inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
- regional enteritis
- zinc deficiency
Specific medications:
In addition to cancer treatments, several drugs can reduce lymphocytes. Medication-induced lymphocytopenia ranges from minor to severe.
The following medications may lower your lymphocyte level:
- Azathioprine (Imuran, Azasan)
- Carbamazepine (Tegretol, Epitol)
- Cimetidine (Tagamet)
- Corticosteroids
- Dimethyl fumarate (Tecfidera)
- Imidazoles
- Interferons
- Methotrexate (Trexall, Rasuvo)
- Opioids
- Certain bisphosphonate therapy for osteoporosis
Kidney disease:
Kidney disease, particularly late stage chronic disease, can reduce the number of T cells in the blood, but lymphocytopenia can also occur in acute kidney injury.
Trauma and surgery:
Trauma from an injury or acute emergency such as cardiac failure can lower lymphocyte counts. Undergoing surgeries such as cardiac bypass can also cause lymphocytopenia.
Other causes:
Other causes of lymphocytopenia include stress and alcohol misuse.
Additionally, there is a rare condition known as idiopathic CD4-positive lymphocytopenia, in which the cause is unknown.
What are potential treatment options?
Treatment depends on the cause and treating the underlying factor usually resolves lymphocytopenia. You may also require therapy to prevent infections or other complications due to a compromised immune system.
If a medication is causing low counts, your doctor may stop or change the medication. Drug-related lymphocytopenia usually clears up after a person stops taking the drug.
Prevention:
You may not be able to fully prevent lymphocytopenia, but you can help boost your immune system and protect yourself against infections. Follow a healthy diet plan, get plenty of rest, and avoid germs as your body recovers its lymphocyte levels.
- Eat a nutrient-rich diet to feel better and more energized. Your doctor or nutritionist can help you choose whole foods that are right for you and are packed with protein and healing minerals and vitamins.
- Wash your hands thoroughly with warm, soapy water several times a day to help prevent illness. Use a hand sanitizer if you’re out and avoid crowded areas.
- Stay away from animals or ask someone else to clean up after pets.
- Be very careful or avoid activities that may cause cuts, scrapes, or even nicks on your skin.
- Ask friends and family members to delay visiting you if they’re not feeling well.
Additional notes:
Lymphocytopenia is a common diagnosis from a complete blood count test. Some people may have values slightly less than the usual range without any reason. Low counts are also common in older adults with no concerning symptoms.
This condition may reflect illness, recent surgery, or drug therapy and is usually reversible. Your doctor will look over your current and previous medical history to see if the lymphocytopenia is a new condition. Most cases resolve spontaneously without medical care.
If you receive a diagnosis of acute lymphocytopenia, your doctor will carefully monitor your levels with follow-up blood tests. You may need further tests and treatment to address the main cause. This may involve specialist referrals, blood tests, imaging, or a bone marrow biopsy.
