Leukopenia
Background
- Low or absent white blood cell count
- Neutropenia is a subset
Clinical Features
- Immunosuppression--> increase risk of infection, including opportunistic pathogens
- +/- signs/symptoms of underlying disease
Differential Diagnosis
- Malignancy (infiltration in leukemia, myeloproliferative disorders or bony metastases)
- B12 or folate deficiency
- Aplastic anemia
- Infection
- Sepsis
- Acute viral infection (e.g. URI, influenza, HIV)
- HIV/AIDS
- Typhoid, dengue, malaria, rickettsia, lyme
- Autoimmune disorders (e.g. SLE, Crohn's, RA)
- Drugs/tox
- Chemotherapeutics (antineoplastics, hydroxyurea, methotrexate)
- Radiation exposure
- Clozapine, chlorpromazine
- Phenytoin
- Sulfonamides, penicillin, cephalosporins, antiretrovirals
- Cimetidine
- Hypersplenism/splenic sequestration
- Miscellaneous
- Congenital, cyclic, "chronic benign neutropenia"
Evaluation
- Assess for infection
- Further evaluation dependant on presentation
Management
- Low threshold for empiric antimicrobials if any concern for infection
- May need only outpatient specialist referral if otherwise asymptomatic
Disposition
- Dependant on presentation
External Links
References
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