What causes leukopenia
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Causes of Leukopenia: An Overview
Leukopenia, characterized by a reduction in the number of white blood cells (leukocytes), can arise from a multitude of conditions. Understanding the underlying causes is crucial for effective diagnosis and treatment. This article synthesizes research findings on the various causes of leukopenia.
Infectious Causes of Leukopenia
Bacterial, Viral, and Protozoal Infections
Infections are a leading cause of leukopenia. Bacterial infections such as typhoid fever, viral infections including measles, influenza, and infectious hepatitis, and protozoal infections like malaria can all lead to a decrease in leukocyte counts 1. Overwhelming infections, such as septicemia and miliary tuberculosis, are also significant contributors 1.
Klebsiella Pneumonia Bacteremia
Klebsiella pneumonia bacteremia has been specifically linked to leukopenia. Research using immunoproteomic analysis identified several pathogenicity factors, including S-adenosylmethionine synthetase and elongation factor tu (EF-Tu), which are associated with leukopenia in these infections 2.
Hematopoietic Disorders and Autoimmune Diseases
Familial Mediterranean Fever (FMF)
Familial Mediterranean fever (FMF) is an unusual but notable cause of leukopenia. The condition is characterized by episodic and self-limited leukopenia due to autophagy and apoptosis processes 3. Recognizing FMF early can prevent unnecessary invasive procedures and complications such as amyloidosis 3.
Hashimoto's Disease
In patients with Hashimoto's disease, treatment with L-thyroxine (L-T4) can induce leukopenia. This is thought to be mediated by suppressor-cytotoxic T cells (OKT8+T cells), although other immune mechanisms may also play a role 4.
Nutritional Deficiencies and Secondary Causes
Vitamin B12 Deficiency
Nutritional deficiencies, particularly vitamin B12 deficiency, are common secondary causes of leukopenia. This condition is often seen in conjunction with infections, which can exacerbate the reduction in leukocyte production and increase their destruction 6.
Chemical and Physical Agents
Drug-Induced Leukopenia
A wide range of chemicals and drugs can induce leukopenia. This man-made condition can be life-threatening if not promptly recognized and managed 1.
Hemodialysis
Hemodialysis using cellophane membranes can cause acute leukopenia due to complement activation. This leads to granulocyte and monocyte entrapment in the pulmonary vasculature, resulting in transient leukopenia 10.
Rare and Miscellaneous Causes
In Vitro Leukoagglutination
Leukopenia can also occur due to in vitro leukoagglutination, a rare hematological finding often provoked by ethylene diamine tetra acetic acid (EDTA) in blood samples. This pseudo-leukopenia can lead to unnecessary investigations and altered management plans 5.
Congenital and Malignant Conditions
In children, rare causes of leukopenia include congenital myelopathy and malignant hematological diseases. These conditions often involve a production defect in the bone marrow, increasing the risk of infections 9.
Conclusion
Leukopenia is a multifaceted condition with numerous potential causes ranging from infections and autoimmune diseases to nutritional deficiencies and drug reactions. Accurate diagnosis and understanding of the underlying cause are essential for effective management and treatment.
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