Lymphocytes are low in an adult - what does this mean and how to treat

Lymphocytes - what are they, what are they?

Lymphocytes are one of the components of white blood cells; a complete blood test for lymphocytes . They play an important role in the formation of immune responses. Their function is to recognize pathogens and mutated own cells. After identifying a foreign object, lymphocytes destroy it in one way or another: phagocytosis, production of special antigens. To destroy their own cells that have degenerated into cancer or have undergone other changes, lymphocytes send a special chemical signal that causes such a cell to start the process of self-destruction. In addition to a general blood test for lymphocytes, a biochemical blood test is performed at the MedArt Medical Center.

There are three types of these cells:

1. T lymphocytes. They mature in the thymus. They play an important role in the fight against foreign bodies and infections. Some T-lymphocytes perform regulatory functions and are responsible for the duration and strength of the immune response. It is these cells that are affected when infected with HIV.
2. B lymphocytes. Their main task is to produce antibodies against viruses and other infectious agents. In addition, they are able to retain information about past diseases, thereby creating permanent immunity.
3. NK – cells. Their main function is to detect and eliminate body cells that have degenerated into malignant ones.

Lymphocytes are formed in the red bone marrow; their young, immature forms are called lymphoblasts. Maturation occurs in several stages, occurring not only in the bone marrow, but also in the lymphoid nodes and other organs of the lymphatic system.

The appearance of an increased number of lymphocytes can serve as a marker of bone marrow pathologies and the development of tumor processes in it. An increase in the level of lymphoblasts is also recorded during prolonged infectious processes. In this case, this serves as a sign of depletion of the body's defenses. The immune system does not have time to prepare a sufficient number of lymphocytes to fight the pathogen, and this becomes the reason for the appearance of a large number of lymphoblasts in the blood.

Forecast

Lymphocytopenia is quite often a predictor of an unfavorable prognosis and is associated with an increased risk of infectious diseases and activation of opportunistic microflora. The outcome and life expectancy of patients are determined by the underlying pathology against which the lymphopenia occurred. The most benign is lymphocytopenia, which develops after prolonged stress or protein starvation. Hereditary immunodeficiency conditions and oncohematological diseases are characterized by a high probability of death in the early stages.

Indications for analysis

A general blood test for lymphocytes is prescribed if there is a suspicion of an increase or decrease in their number. The analysis can be prescribed for other reasons; it allows you to obtain a lot of valuable data about the state of the blood and the whole body. The main indications include:

• Detection of the immune response to the presence of pathogenic microorganisms.
• The state of human immunity.
• Physical and chemical composition of blood.
• Preventive analysis - to detect hidden changes in the blood formula that do not manifest themselves with specific symptoms.

Preparing for analysis

The analysis for lymphocytes is included in the general blood test, the rules for their conduct are the same. That is, such an examination does not require special preparation. There are only two conditions that must be met:

• Blood is taken in the morning.
• 8-12 hours before blood sampling you need to abstain from food.

You should also not smoke 2-3 hours before the procedure. Components of tobacco smoke can cause serious temporary changes in white blood cell levels. You should avoid drinking alcohol 2-3 days before taking the test, as alcohol can also affect the reliability of the results obtained.

If these requirements are not met, the accuracy of the examination may deteriorate, which will lead to the doctor receiving unreliable information and possible errors in diagnosis or re-prescribing the examination.

Causes of lymphocytopenia

Physiological processes

Lymphocytopenia is not necessarily a sign of any disease. The cause may be various physiological conditions, for example, prolonged stress. When stressed, adrenal hormones (glucocorticosteroids) are released into the blood, which have a destructive effect on lymphocytes. Lymphocytopenia can also occur with protein deficiency, so it often occurs during fasting or in people following a vegetarian or vegan diet.

Viral infections

Under the influence of some lymphotropic viruses, accelerated death of lymphocytes occurs. The most common and dangerous infectious cause of lymphocytopenia is the human immunodeficiency virus (HIV). It binds to special receptors (CD4) on the surface of T-lymphocytes (T-helpers), penetrates into the cell, where it actively multiplies and leads to its death. A decrease in the number of T helper cells occurs both due to the direct damaging effect of the virus and due to the activation of apoptosis (programmed cell death) and autoimmune damage.

At the very beginning of infection, the level of lymphocytes can, on the contrary, increase with the development of leukocytosis as an immune reaction to a foreign microorganism, but then there follows a rapid drop in the concentration of white blood cells until their complete absence, which is associated with the development of acquired immunodeficiency syndrome, the increased susceptibility of the patient’s body to various infections, including opportunistic ones. Lymphocytopenia may begin to regress only after long-term antiretroviral therapy.

In addition, the following viral infections contribute to the destruction of lymphocytes, in which lymphocytopenia is much less pronounced than with HIV:

• Measles.
  It is a common cause of lymphocytopenia in children. The measles virus causes the death of follicular B lymphocytes. Even after recovery, immunosuppression may persist for several weeks or months. The measles virus also damages immunological memory cells, causing temporary “immune amnesia.”
• Respiratory syncytial infection.
  It is considered the leading cause of lower respiratory tract disease in infants and young children.
• Flu.
  The development of lymphocytopenia often occurs in adults with severe influenza A1, swine and bird flu. Its occurrence is a predictor of serious complications and poor prognosis.
• SARS (acute respiratory syndrome, atypical pneumonia).
  The causative agent is coronavirus. It is assumed that the cause of lymphocytopenia is the induction of cytokine release syndrome (cytokine storm) by the virus, leading to the death of immune cells.

Bacterial infections

Lymphocytopenia can also be caused by some bacterial infections - leptospirosis, ehrlichiosis, legionellosis. Lymphopenia is of greatest importance in such common infections as tuberculosis (miliary, disseminated). With this disease, there is a decrease in T-helper cells and T-suppressor cells (CD4, CD8 cells). Pathology occurs in septic conditions (bacterial blood infection). Absolute lymphocytopenia indicates an unfavorable course of any bacterial infection. The indicators quickly return to normal after antibacterial and anti-tuberculosis therapy.

Autoimmune diseases

Another cause of lymphocytopenia is chronic inflammatory diseases of an autoimmune nature. Numerous studies have revealed two main pathogenetic mechanisms of lymphopenia in these pathologies: the release of antilymphocyte antibodies and a decrease in the expression of special proteins (CD55, CD59) on the membranes of immune cells that protect cells from complement-mediated cytolysis. Lymphocytopenia is usually moderate, may correlate with the severity of the disease, and regresses during remission or under the influence of pathogenetic treatment.

• Joint diseases.
  Rheumatoid arthritis.
• Diffuse connective tissue diseases (collagenoses).
  Systemic lupus erythematosus, Sjögren's syndrome.
• Systemic vasculitis.
  Granulomatosis with polyangiitis, Takayasu nonspecific aortoarteritis.
• Inflammatory bowel diseases (IBD).
  Nonspecific ulcerative colitis, Crohn's disease.
• Multiple sclerosis.

Lymphoproliferative diseases

Oncohematological pathologies, such as lymphogranulomatosis (Hodgkin's lymphoma), T-B cell lymphomas, lymphosarcoma, can also cause lymphocytopenia. It usually develops in the later stages of the disease and is considered one of the criteria for an unfavorable outcome. The drop in the level of lymphocytes is due to the depletion of lymphoid tissue and the replacement of hematopoietic tissue with atypical malignant cells.

Rare causes

• Inhibition of lymphocyte formation
  : hereditary immunodeficiencies (Wiskott-Aldrich syndrome, DiGeorge syndrome), diseases accompanied by the replacement of lymphoid tissue with epithelioid granulomas (sarcoidosis, histiocytosis X), exposure to ionizing radiation, aplastic anemia.
• Lymph loss:
  damage to large lymphatic ducts during trauma and abdominal surgery, massive burns, primary intestinal lymphangiectasia (Waldmann's disease).
• Accelerated destruction of lymphocytes
  : endocrine disorders (Cushing's disease and syndrome, type 1 diabetes), end-stage chronic renal failure.
• Use of medications:
  glucocorticosteroids, immunosuppressants (methotrexate, azathioprine), monoclonal antibodies.
• Diseases with an unknown mechanism of lymphocytopenia:
  malignant neoplasms - breast, thyroid, rectal cancer.

Research method

Material for analysis of lymphocytes is collected from a vein using a conventional syringe or a special vacuum system. The traditional technique of taking an analysis using a conventional syringe is currently outdated and can lead to the following difficulties:

• Blood clotting in a needle.
• Destruction of some blood cells.
• Long manipulation time.
• Contact of blood with the environment
• It is difficult to maintain the correct ratio of blood and reagents. In addition, the traditional technique does not exclude contact of medical personnel with the patient’s biomaterial, which can pose a health hazard. Therefore, many clinics use modern vacuum containers for blood collection.

Blood enters it due to the vacuum in the test tube; all parameters of the vacutainer are selected at the production stage in order to reduce the time for blood collection and ensure the correct ratio of the amount of reagent and blood.

Advantages of vacuum systems:

• A standardized blood collection process that takes minimal time.
• Contact of medical staff with the patient’s blood is completely excluded.
• Simple labeling and identification of samples, eliminating confusion with tubes.
• Almost painless procedure.

You can take blood for a general analysis from a finger, but at the moment this procedure is used much less frequently.

Treatment

The first question that concerns patients is what to do if lymphocytes are low? First of all, you should calm down. The doctor will prescribe additional tests that will help determine the cause of the deviation from the standard values. It is necessary to re-determine the level of lymphocytes in order to exclude erroneous data.

After a final diagnosis has been established, adequate treatment methods are selected that are aimed at eliminating the cause. It is forbidden to try to cure yourself using diets and alternative medicine methods. Their use is justified exclusively as accompanying methods during drug therapy and after consultation with the attending physician.

Norms

The normal level of lymphocytes in the blood depends on the age of the patient. In children, the number of lymphocytes is higher; over time, this figure gradually decreases. The number of these cells is influenced by the gender of the patient; in women the indicator is relatively higher. This is due to the greater activity and adaptive capacity of the lymphatic system of the female body.

Lymphocytes are increased

The reason why lymphocytes are elevated is often a variety of viral infections. This increase is called lymphocytosis, and is most often recorded in diseases caused by viruses:

• Epstein-Barr.
• Adenovirus.
• Herpes.
• Childhood infections (rubella, measles, mumps).

The number of lymphocytes may increase with some bacterial infections, such as syphilis, whooping cough, or tuberculosis. Diseases caused by protozoa, such as malaria and toxoplasmosis, can lead to lymphocytosis. Often, an increase in lymphocytes is caused by helminthic infestations.

Lymphocytes may be elevated for reasons unrelated to infection. These include:

1. Hypersensitivity reactions.
2. Stress lymphocytosis.
3. Autoimmune diseases.
4. Disorders of the endocrine organs, especially the thyroid gland.
5. Development of tumors and pretumor processes.

The most striking signs of an increase in the number of lymphocytes include:

• Enlarged liver, spleen, lymph nodes.
• General malaise, manifestations of respiratory infections, redness and swelling of the mucous membranes.
• A sharp increase or decrease in temperature, accompanied by chills.
• Dyspeptic symptoms - vomiting, stool disorders, nausea.
• Nervous system disorders due to elevated temperature.

It should be borne in mind that lymphocytosis does not always manifest itself through severe symptoms. Often, elevated levels of these cells are discovered by chance. Only a doctor can accurately determine the reason why a change in the blood formula occurred; this often requires additional tests.

To eliminate lymphocytosis, you need to cure the disease that led to an increased immune response. It is important to understand that the hematopoietic system responds to recovery with a certain delay. Even after complete recovery, lymphocytosis can persist for up to several months.

Correction

There are no ways to independently relieve lymphocytopenia. To normalize the level of lymphocytes, it is necessary to eliminate the cause, namely, treat the underlying pathology. If lymphocytopenia occurs due to stress or protein deficiency in the diet, treatment is not required, it is enough to adjust the diet. For persistent, long-term lymphopenia, medical intervention is necessary. Depending on the reason, the following measures are applied:

• Fighting infection.
  To treat HIV infection, antiretroviral therapy is prescribed - nucleoside reverse transcriptase inhibitors, protease inhibitors (saquinavir). Oseltamivir is indicated for influenza. For the treatment of other viral infections, there are no etiotropic medications; symptomatic methods are used (antipyretics, detoxification therapy). For nonspecific bacterial infections, antibiotics are recommended; for tuberculosis, combinations of antituberculosis drugs (isoniazid, rifampicin).
• Anti-inflammatory therapy.
  To achieve remission of autoimmune diseases, medications are used that suppress the inflammation process - glucocorticosteroids, synthetic derivatives of aminoquinoline and 5-aminosalicylic acid, immunosuppressants (methotrexate, cyclophosphamide).
• Treatment of lymphoproliferative diseases.
  For lymphogranulomatosis and non-Hodgkin's lymphomas, polychemotherapy (vincristine, dacarbazine, etoposide) is indicated. Irradiation of tumor-affected lymph nodes is effective.

Lymphocytes are low

A decrease in lymphocytes is called lymphopenia. This condition is typical for the following diseases:

• AIDS.
• Long-term, severe infections.
• Bone marrow pathologies.
• Tumors of lymphatic tissues.
• Exposure to radiation.
• Taking certain groups of drugs, such as cytostatics.
• Pregnancy.

In most cases, a decrease in the level of lymphocytes indicates a depleted immune system, when the body, for various reasons, is unable to maintain the required level of these cells in the blood.

Lymphopenia rarely presents with characteristic symptoms. The most common signs of this condition include:

• Reduction or complete absence of tonsils and other peripheral lymph nodes.
• Skin diseases - eczema, pyoderma.
• Common signs of blood diseases are ulcers of the oral mucosa, petechiae, pallor, and jaundice.
• Enlarged liver and spleen.

As in the case of lymphocytosis, to normalize the level of these cells, it is necessary to eliminate the cause that led to the pathological condition. You need to see a doctor who can establish an accurate diagnosis and prescribe the correct treatment regimen.

In the case of lymphopenia in pregnant women, with a moderate decrease in the level of lymphocytes, there is no need to take special measures. Enhanced monitoring of your health status and regular completion of all necessary examinations is sufficient. If there is a sharp drop in lymphocytes, you should seek medical help for additional diagnostics.

How to quickly increase the level of lymphocytes in the blood of women

If you have a weakened immune system, for example due to illness or an unhealthy lifestyle, your lymphocyte levels will drop.

This treatment of lymphopenia using traditional methods does not apply to cases where a visit to a doctor is required and self-medication is contraindicated!

1. Reduce the amount of fatty foods in the diet, as they weaken lymphocytes.

2. Consume as much protein as possible - a source of essential amino acids necessary to maintain immunity.

3. Add vitamin C, beta-carotene, zinc, selenium to the menu. These substances help the body produce lymphocytes.

To restore immunity, it is not enough to adjust your diet - you will also have to change your lifestyle.

Exercising and maintaining a healthy weight helps white blood cells work properly.

It is also important to avoid negative situations and conflicts with others, as stress suppresses the immune system.