48 LEUKOPENIA General Discussion The normal peripheral white blood cell count ranges from 5.0 to 10.0 × 109/L. Leukopenia is defined as a total WBC count below 4.5 × 109/L. When leukopenia is discovered, the first step is to determine which type of WBC is at lower levels than normal. Neutropenia occurs when a patient’s peripheral neutrophil count is less than 2.0 × 109/L. The normal range in Yemenite Jews and African Americans is somewhat lower, and neutropenia is defined as counts less than 1.5 × 109/L in these populations. The risk of bacterial infection is substantially increased when the peripheral neutrophil count falls below 0.5 × 109/L. The diagnostic evaluation of neutropenia must first address whether the patient has fever, sepsis, or both. The most frequent cause of acquired neutropenia is medication. Any drug should be considered to be a potential cause until proved otherwise. Neutropenia may also occur as a manifestation of a wide variety of systemic diseases. Infection is a common cause of neutropenia, particularly viral infections and sepsis. Normal lymphocyte counts range from 2 to 4 × 109/L, with approximately 20% B lymphocytes and 70% T lymphocytes. Lymphocytopenia is defined as a peripheral blood lymphocyte count below 1.5 × 109/L. Protein-calorie malnutrition is the most common cause of lymphocytopenia worldwide. There generally are no specific clinical manifestations of lymphocytopenia. However, the patient may exhibit signs of immunologic deficiency depending upon the underlying cause of the lymphocytopenia, the degree of immunodeficiency, and the duration of the disease. Medications Associated with Neutropenia Acetazolamide Alkylating agents Allopurinol Aminopyrine Anthracyclines Brompheniramine Captopril Carbamazepine Chloramphenicol Chlorpromazine Chlorpropamide Chlorthalidone Cimetidine Cisplatin Clozapine Dactinomycin Dapsone Ethosuximide Ganciclovir Gold salts Hydrochlorothiazide Hydroxyurea Ibuprofen Indomethacin Isoniazid Levamisole Mephenytoin Methimazole Methyldopa Nitrofurantoin Para-aminosalicylic acid Penicillamine Penicillins Phenylbutazone Phenytoin Procainamide Prochlorperazine Promazine Propranolol Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS HYPOTHYROIDISM SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on LEUKOPENIA Full access? Get Clinical Tree
48 LEUKOPENIA General Discussion The normal peripheral white blood cell count ranges from 5.0 to 10.0 × 109/L. Leukopenia is defined as a total WBC count below 4.5 × 109/L. When leukopenia is discovered, the first step is to determine which type of WBC is at lower levels than normal. Neutropenia occurs when a patient’s peripheral neutrophil count is less than 2.0 × 109/L. The normal range in Yemenite Jews and African Americans is somewhat lower, and neutropenia is defined as counts less than 1.5 × 109/L in these populations. The risk of bacterial infection is substantially increased when the peripheral neutrophil count falls below 0.5 × 109/L. The diagnostic evaluation of neutropenia must first address whether the patient has fever, sepsis, or both. The most frequent cause of acquired neutropenia is medication. Any drug should be considered to be a potential cause until proved otherwise. Neutropenia may also occur as a manifestation of a wide variety of systemic diseases. Infection is a common cause of neutropenia, particularly viral infections and sepsis. Normal lymphocyte counts range from 2 to 4 × 109/L, with approximately 20% B lymphocytes and 70% T lymphocytes. Lymphocytopenia is defined as a peripheral blood lymphocyte count below 1.5 × 109/L. Protein-calorie malnutrition is the most common cause of lymphocytopenia worldwide. There generally are no specific clinical manifestations of lymphocytopenia. However, the patient may exhibit signs of immunologic deficiency depending upon the underlying cause of the lymphocytopenia, the degree of immunodeficiency, and the duration of the disease. Medications Associated with Neutropenia Acetazolamide Alkylating agents Allopurinol Aminopyrine Anthracyclines Brompheniramine Captopril Carbamazepine Chloramphenicol Chlorpromazine Chlorpropamide Chlorthalidone Cimetidine Cisplatin Clozapine Dactinomycin Dapsone Ethosuximide Ganciclovir Gold salts Hydrochlorothiazide Hydroxyurea Ibuprofen Indomethacin Isoniazid Levamisole Mephenytoin Methimazole Methyldopa Nitrofurantoin Para-aminosalicylic acid Penicillamine Penicillins Phenylbutazone Phenytoin Procainamide Prochlorperazine Promazine Propranolol Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS HYPOTHYROIDISM SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on LEUKOPENIA Full access? Get Clinical Tree
