When you go to the hospital, it's inevitable that you'll have to do some tests, and the most common test is the blood test.

Through the blood routine, you can find out whether there is anemia, whether there is thrombocytopenia, and more importantly, to see the number of white blood cells and the composition of the proportion.

One 35-year-old woman, a hepatitis B carrier, had no hepatitis episodes and was regularly reviewed every three months.

But recently the patient occasionally checked a routine blood test, found that leukopenia, only 3400, self-conscious more tired, liver function, ultrasound and other tests are not a problem, there is no cause of leukopenia of liver disease factors (mainly cirrhosis caused by splenic hyperfunction)

The patient had a short period of time before the "cold" that manifested as fever, headache, sneezing, and runny nose, which resolved in a few days.

Leukopenia is not uncommon in clinical practice. In addition to viral infectious diseases such as "colds", leukopenia can occur in cirrhosis of the liver, typhoid fever, post-chemotherapy, interferon, and so on.

Today, Dr. Long will talk about low white blood cells.

It is important to note that some leukopenia can be due to hematologic disorders, which require a hematologist's attention and are beyond the scope of this article.

Low white blood cell count refers to a peripheral blood white blood cell count less than 4000/μL (i.e., 4.0×10∧9/L, the same below), and many hospitals have inconsistent reference values for blood counts, so it is important to take the lower limit of the reference value below that on the report card as a basis for judgment.

White blood cell count, is the total number of a series of white blood cells, including lymphocytes and so on.

Lymphocytes, monocytes, eosinophils or basophils, etc. have an effect on the total number of white blood cells, but because neutrophils are in the majority, the count is usually caused by a decrease in the number of neutrophils.

What is commonly referred to as low leukocytes is usually neutropenia.

Neutropenia, a peripheral blood neutrophil count less than 1500/μL, is more severe than leukopenia alone when accompanied by monocytopenia and lymphopenia.

Significant neutropenia, even below 1000/μL, can make patients significantly less resistant to bacteria and fungi and susceptible to infections, because neutrophils are the body's main line of defense against bacterial and fungal infections.

Neutrophils below 500/μL, known as neutrophil deficiency, are prone to serious infections such as sepsis and septicemia, a condition that indicates that pathogens are constantly localizing the infection and also making their way into the bloodstream.

The body's inflammatory response to infection is also reduced, for example, some older people, frail people or children, serious infections, not even fever, manifested as hypothermia, and inflammatory defense response failure have a certain relationship.

The human body oral cavity, pipe, skin performance of some of the normally non-pathogenic resident bacteria (also known as normal flora), can also take advantage of the opportunity to multiply, invasion of infrequent sites, causing infection, called opportunistic infections .

In combination with other factors that weaken the body's immune system, such as cancer, this can cause rapid, fatal infections that require special attention.

Low neutrophils also have a significant impact on infections when the integrity of the body's skin and mucous membranes is compromised and malnutrition is present.

Severe neutropenia, the most common suppurative infections, are: cellulitis, liver abscesses, boils, pneumonia, and sepsis.

Clinically, when leukopenia is detected, further management and decision-making is based on the specific situation:

First, it is necessary to determine whether an infection is present

A systematic physical examination is performed on the sites where infections most commonly occur, including the skin, nails, mucosal surfaces (gums, pharynx, etc.), urethra, lungs, abdomen, and venipuncture sites.

Secondly, tests should be done to determine the site of infection

Patients with leukopenia associated with fever, it is best to perform blood culture tests;

Suspecting urinary tract or lung infection, it is necessary to do urine, sputum culture;

If diarrhea is present, fecal pathogenesis is also important;

Repeated fever and leukopenia may require bone marrow aspiration smears and cultures to further define the cause.

Acute neutropenia is suspected in the presence of infection and requires immediate treatment.

A fever with low blood pressure suggests a serious condition and requires high-dose antibiotic therapy based on the physician's clinical experience, as well as fluid replacement to correct infection-induced hypovolemia or shock.

To prevent opportunistic infections associated with leukopenia, skin and mucosal hygiene, especially oral hygiene, is required.

It is recommended that saline or hydrogen peroxide mouthwash rinse every 2-3 hours to minimize bacterial and fungal infections invading from the oral mucosa.

For those who have a loss of appetite, they should be given a liquid or semi-liquid diet, paying attention to the intake of vitamins and protein supplements; such as increasing the intake of eggs, lean meat, fish, milk, and eating more vegetables and fruits.

Granulocyte-macrophage colony-stimulating factor is now widely used in patients with severe neutropenia to increase neutrophil production and prevent infections, and should be used under medical supervision.

Simple mild leukopenia without symptoms, if there is no lymph node swelling, splenomegaly and other manifestations, do not necessarily need to use drugs to raise white blood cells.

The usual diet, if the lack of vitamin B12, folic acid, copper, etc., may also lead to neutropenia, you can eat more green leafy vegetables, grains, beans, lean meat, liver, fish and poultry, etc., and women of childbearing age are advised to take folic acid supplements as required.

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