Low Lymphocyte Count (Lymphocytopenia)

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low lymphocyte count lymphocytopeniaLow lymphocyte count, also known as lymphocytopenia, is a cause for concern because when lymphocytes (a type of white blood cell) are low, the body’s ability to repel infections is weakened.

These cells help prevent infections by bacteria and viruses and also fight off infections already present, and a low count of these cells also increases the chance of certain types of cancer developing, mostly types of leukemia, lymphoma, and Hodgkin’s lymphoma.

There are three types of lymphocytes: B cells, T cells, and natural killer (NK) cells. These white blood cells make up about 20 to 40% of all white blood cells in the body, and the normal range for lymphocytes is a count of 1,000 to 4,800 cells per microliter of blood.

What Does it Mean if You Have Low Lymphocytes?

To have low lymphocytes means to have a low absolute lymphocyte count. The three types of lymphocytes (B, T, NK) are necessary because all three play important roles in how the immune system functions optimally. Having not enough B cells can lead to a decrease in the number of plasma cells, and these cells produce antibodies (a protein in the blood that works with the immune system to fight off bacteria and viruses).

A reduction in the production of antibodies can cause an increase in bacterial infections. A low number of T cells or NK cells can result in problems controlling certain infections, especially if they’re viral, fungal, or parasitic. Severe lymphocyte deficiencies can lead to in uncontrolled infections, which may be fatal. Low lymphocyte count causes are varied and stem from a number of diseases and conditions.

What Causes Low Lymphocytes?

A number of factors contribute to a low lymphocyte count: general causes, acquired causes, and inherited causes. There are acute and chronic causes. An acute cause is one that appears but goes away because the issue is resolved. Chronic causes, on the other hand, take place over a longer period of time, most likely because of a long-lasting disorder.

1. General Causes

In simple terms, low white cell production with lymphocytes occurs for a few reasons: the body simply doesn’t make enough of them; the body makes enough but they get destroyed; or the lymphocytes get caught in the lymph nodes or in the spleen. Fasting, intense physical stress, chemotherapy/radiation therapy for cancer, and viral infections such as the flu and hepatitis can also cause acute lymphocytopenia.

2. Acquired Causes

Acquired causes, meaning those that you were not born with but developed at some point in life, are most often connected to underlying medical health conditions or responses to other medical treatments. Some examples of acquired causes are:

  • Infectious diseases
  • Autoimmune disorders
  • Steroid therapy
  • Blood cancers and blood diseases
  • Radiation/chemotherapy

3. Inherited Causes

Inherited causes, which are those passed down to you genetically by your parents, are almost always linked to defects in the genes that are part of lymphocyte development. Some of these diseases include the following:

  • DiGeorge anomaly
  • Wiskott-Aldrich syndrome
  • Severe combined immunodeficiency syndrome
  • Ataxia-telangiectasia

It’s not yet known how these diseases, conditions, or factors affect lymphocyte count; in fact, some people have a low lymphocyte count with no known underlying cause. More research needs to be done to gain a fuller understanding.

What Is the Normal Range of Lymphocytes?

Lymphocyte levels can be determined and analyzed through a blood test.

  • The range value is calculated per milliliter of blood, and the normal range for lymphocytes is typically between 1,300 and 4,000 cells per milliliter.
  • A percentage can also be used, but if it is, the figure tends to include all three types of lymphocytes: T-cells, B-cells, and NK cells.
  • The percentage range should be between 20 and 40% of the total white blood cell count.

Symptoms of Low Lymphocytes Count

Trying to diagnose a low lymphocyte count is tricky, because on its own the condition doesn’t present with any signs or symptoms; it’s typically noticed only when blood tests are done for other diseases and conditions. If symptoms do present themselves in mild cases of lymphocytopenia, they would look something like the following, (and as with anything it can vary from person to person):

  • Enlarged lymph nodes and spleen. This indicates the presence of cancer or an HIV infection. In this case, a low lymphocyte count can mean cancer.
  • Cough, runny nose, and fever, which indicate a respiratory viral infection.
  • Small tonsils or lymph nodes, which indicate a genetic immune system disorder.
  • Swollen, painful joints and a rash. This indicates the presence of rheumatoid arthritis or systemic lupus erythematosus.

When the number of lymphocytes is reduced considerably, it can lead to repeated infections by way of bacteria, viruses, fungi, and parasites.

An abnormal increase in one type of white blood cell can cause a decrease in the number of other types of white blood cells, which means that it’s possible to have, for example, both a low lymphocyte count and a high neutrophil count.

How Are Low Lymphocytes Diagnosed?

Despite whatever symptoms and signs might be presenting themselves, the answers are all in the blood—that is, the only way low lymphocytes can be diagnosed is through a complete blood panel workup done by your doctor. While symptoms may lead your doctor to believe that there is an issue, the only way to confirm the diagnosis is by drawing blood and analyzing it.

  • When the lymphocyte count is low or reduced, your doctor will test for HIV and other infections with another blood test. In rare cases, a bone marrow sample will be extracted so it can be studied under a microscope.
  • The blood tests will also determine the types of lymphocytes (T-cells, B-cells, and NK cells) in the blood. Some disorders, such as AIDS, are determined by a reduction in some kinds of lymphocytes, as are particular disorders related to hereditary immunodeficiency.

Low lymphocyte counts related to lymphoma (a group of blood cancers that develop in the lymphatic system, most notably Hodgkin’s lymphoma and non-Hodgkin’s lymphoma) are diagnosed through blood tests as well.

How to Treat Low Lymphocytes

How you treat low lymphocytes depends entirely on what’s causing the problem.

1. Drug-Related Causes

If a drug causes lymphocytopenia, then it will usually resolve on its own within time and no other intervention is required.

2. AIDS-Related

If the cause of the lymphocytopenia is AIDS, then the course of treatment is a combination therapy approach where three antiviral drugs are administered (at a minimum) so that T-cell counts can be increased and the chance of survival lengthened.

3. Disease or Illness Related

If the lymphocytopenia is related to an illness or simple disease, the doctor will treat that underlying condition accordingly, depending on what it is. Over time, the white blood cell count should return to normal. If not, further investigation and testing will need to be done.

4. Mild Cases of Low White Blood Cell Count

In mild lymphocytopenia where there is no underlying cause, no treatment is offered as the situation will likely improve on its own over time.

5. Genetic Aberrations

When a genetic defect is the cause of lymphocytopenia, a blood stem cell transplant or a bone marrow stem cell transplant might be viable options considered by your doctor as a low lymphocyte count treatment.

Dietary Guidelines for a Low Lymphocyte Count

Lymphocytes have a big role to play in fighting off pathogens that try to attack the body through the immune system. Eating a diet rich in vitamins and nutrients provides your immune system with the armor it needs to fight off bacteria and viruses that could potentially result in low white blood cell counts. Below are a few dietary guidelines to assist your body during this time.

  • Eat lots of protein. The amino acids in the protein will help the lymphocytes function properly and keep your immune system strong.
  • Make sure you get enough vitamin A in your diet. Eat plenty of leafy greens and orange vegetables.
  • Boost vitamin B6 levels by eating salmon, turkey, or chicken. Vitamin B6 helps lymphocytes develop properly.
  • Drink green tea every day.
  • Avoid high-fat foods.
  • Drink plenty of water.
  • Get more zinc by eating peanuts, almonds, and oysters.

Preventing a Low Lymphocyte Count

One of the most common reasons for lymphocytopenia is AIDS, so the best way to prevent acquiring this autoimmune disease is to:

  • Practice safe sex; and
  • Do not share needles with anyone—better yet, don’t inject drugs into yourself at all.

Sources for Today’s Article:
“What Causes Lymphocytopenia?” National Heart, Lung, and Blood Institute web site;
https://www.nhlbi.nih.gov/health/health-topics/topics/lym/causes, last accessed April 15, 2016.
“Blood Differential Test,” Medline Plus web site;
https://www.nlm.nih.gov/medlineplus/ency/article/003657.htm last accessed April 15, 2016.
“Non Hodgkin Lymphoma,” Leukemia and Lymphoma Society of Canada web site;
http://www.llscanada.org/lymphoma/non-hodgkin-lymphoma?src1=20045&src2=, last accessed April 15, 2016.

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Dr. Richard Foxx, MD

About the Author, Browse Richard's Articles

Richard M. Foxx, MD has decades of medical experience with a comprehensive background in endocrinology, aesthetic and laser medicine, gynecology, and sports medicine. He has extensive experience with professional athletes, including several Olympic competitors. Dr. Foxx practices aesthetic and laser medicine, integrative medicine, and anti-aging medicine. He is the founder and Medical Director of the Medical and Skin Spa located in Indian Wells, California, at the Hyatt Regency Resort. Dr. Foxx is certified by the National Board of Medical Examiners... Read Full Bio »