Lymphocytopenia differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Lymphocytopenia from other Diseases
Lymphocytopenia can be caused by various types of chemotherapy, such as with cytotoxic agents or immunosuppressive drugs. Some malignancies in the bone marrow also cause lymphocytopenia.
People exposed to large doses of radiation, such as those involved with Chernobyl, can have severe lymphocytopenia.
A decreased number of certain types of lymphocytes, notably T cells, is a characteristic of AIDS.
Idiopathic CD4+ lymphocytopenia is the condition of having an abnormally low level of CD4+ T-cells. It has no known cause[1] and is not associated with AIDS or any known infectious agent such as HIV or HTLV.[2] It is associated with higher risks of opportunistic infections and cancer.[3]
Lymphocytopenia may be present as part of a pancytopenia, when the total numbers of all types of blood cells are reduced. This can occur in marrow failure.
Lymphocytopenia, but not idiopathic CD4+ lymphocytopenia, is associated with corticosteroid use, infections with HIV and other viral, bacterial, and fungal agents, Hodgkin's disease, leukemia, malnutrition, systemic lupus erythematosus,[4] high stress levels, whole body radiation, rheumatoid arthritis, and iatrogenic conditions.
In alphabetical order. [5] [6]
- After influenza
- After snakebite
- Anesthesia
- Antibody deficiency syndrome
- Aplastic Anemia
- Banti's Syndrome
- Burns
- Congenital immune deficiency
- Cushing's Disease
- Dermatomyositis
- Drugs, toxins
- Exudative enteropathy
- Felty's Syndrome
- Heavy exercise
- HIV
- Hodgkin's Lymphoma
- Inflammatory Bowel Disease
- Lymphocyte tuberculosis
- Measles
- Paroxysmal nocturnal hemoglobinuria
- Polycythemia
- Postoperative
- Pregnancy
- Sarcoidosis
- Scarlet Fever
- Secondary hypersplenism
- Single non-Hodgkin's lymphomas
- Surgery
- Systemic Lupus Erythematosus
- Trauma
- Tuberculosis
- Uremia
- Whipple's Disease
- Zinc deficiency
References
- ↑ D K Smith, J J Neal, and S D Holmberg. "Unexplained opportunistic infections and CD4+ T-lymphocytopenia without HIV infection. An investigation of cases in the United States". The New England Journal of Medicine. 328 (6): 429–431. PMID 8093633.
- ↑ D D Ho, Y Cao, T Zhu, C Farthing, N Wang, G Gu, R T Schooley, and E S Daar (1993-02-11). "Idiopathic CD4+ T-lymphocytopenia — immunodeficiency without evidence of HIV infection". The New England Journal of Medicine. 328 (6): 386–392. PMID 8093634.
- ↑ Thomas J Spira, Bonnie M Jones, Janet Nicholson, Renu B Lal, Thomas Rowe, Alison C Mawle, Carl B Lauter, Jonas A Shulman, and Roberta A Monson (1993-02-11). "Idiopathic CD4+ T-Lymphocytopenia — An Analysis of Five Patients with Unexplained Opportunistic Infections". The New England Journal of Medicine. 328 (6): 386–392. PMID 8093635.
- ↑ W L Ng, C M Chu, A K L Wu, V C C Cheng, K Y Yuen. "Lymphopenia at presentation is associated with increased risk of infections in patients with systemic lupus erythematosus". Quarterly Journal of Medicine. 99 (1): 37–47. doi:10.1093/qjmed/hci155.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X