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What causes low Lymphocyte count?

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Answered by

General & Family Physician
Practicing since : 2005
Answered : 2568 Questions
Among all other complaints I have had all week about my hormones now I've been hit with more news from my Doctor. I will be seeing a hematologist on tomorrow. I was told my Lymphocyte count was very low. It is 300 and should be 1500 or more. It started by me having leg cramps similar to low potassium so I asked the doctor if I could have my potassium levels checked.. He checked a number of things. He told me my kidneys were stable, my potassium is normal, my hemoglobin is 12.8 which is fantastic for someone with beta thallesemia minor. Then he told me my white blood cell count was 300. He said nothing registered that I had any infection but said to stay away from sick people and fresh cut flowers. What should I be asking my Hematologist tomorrow? I did have my biopsy on my thyroid cyst. I wont know the results until Feb. 14. 2014
Posted Mon, 17 Feb 2014 in Blood Disorders
Answered by Dr. Prasad 7 hours later
Brief Answer: Need clarification... Detailed Answer: Dear, First, I need to confirm which of your blood parameter was low - is it total white blood count and lymphocyte count or is it lymphocyte count alone. So please confirm or better to upload the test results using the site's uploader. Presuming it was total white blood count (WBC), I would first ask my hematologist 1. if the result is clinically relevant and if it needs to be repeated. A low count secondary to recent acute infection (which is most common cause) would improve over couple of week. 2. Should I be tested for chronic infection 3. Do I have other clinical symptoms of tumour? However I am not sure if your hematologist is worried about this result. If he isn't then it is most likely an acute self resolving situation. You can discuss to confirm. Regards
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Follow-up: What causes low Lymphocyte count? 2 hours later
My kidney doctor is the one that actually ordered the labs. He told me is was thr lymphocytes count alone which is 300. He said he even looked back to view earlier labs to see if this count had previously been this low and it wasnt. The kidney doctor spoke with my hematologst and my internal medicine doctor about my blood. I think he may be concerned about it. He said hes hopeful it may be medication related but i needed to be evaluated by the hematologst. This was yesterday and he got me in today. I will see the hematologst at 10am today. I also have a left armpit lymph node that has been swollen for about 4 years now and no one has checked to see why its swollen.
Answered by Dr. Prasad 1 hour later
Brief Answer: Look forward to hematologist evaluation... Detailed Answer: Hi, Medicines especially steroids, cytotoxic drugs and immune suppressor can suppress lymphocytes; I am not sure if you were on any of these before the lab test were ordered. If this is indeed drug induced or from a recent infection, your count should improve in 2-3 weeks. If all your previous labs did not reveal anything significant and you have no other symptoms, I am hopeful that repeat tests should be on the positive side. Please go ahead with the hematologist visit. You might learn about other causes not discussed by your nephrologist. Some books have noted that lymphocytes could be low due to autoimmune reasons, fasting and even stress factors. You can discuss about these aspects during the visit. Off course, the doctor might order further investigations - cluster differentiation, lupus, rheumatoid factor, etc., before answering those questions if he is concerned too. At this point of time, with the limited information provided, I am unable to give you any more details. I look forward to your updates after the hematologist visit. Good luck!! Regards
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Follow-up: What causes low Lymphocyte count? 16 hours later
Okay I went to see the Hematologist today. He said not to worry too much. He said it is one of three things, and he narrows it down because i am his patient and he knows me. He has been treating my anemia and corrected it. So he has been watching my blood in the past. I did get the strait of things. My lymphocyte count should be about 2.4 and it is 87, and my neutrophil count is too low. i don't remember the numbers on that. He repeated the blood work and tested for other things. I will see him on next Thursday for the conclusion. The first thing he said is there may have been an abnormal lab due to mishandling or some type of error. If so, then cased closed. The second thing is my body could be still fighting an infection and hasn't healed yet, if so these counts will get better with time and case closed. The third thing he said is chronic leukemia. Then he went to ask me if I had been having nights sweats, and my answer was yes, yes, yes and terrible. He also felt the swollen lymph in the upper corner of my breast. That didn't seem to concern him a great deal but he did acknowledge it being there. He said if it is Chronic Leukemia, it is a very slow progressing cancer of the blood. I more than likely can lead a normal life and can do everything I have been doing for quite some time (20+ years). He said any of the three has a great prognosis. I felt better when I left the office. But I still don't like the sound of possible leukemia. I must admit that still scares me. Does this sound reasonable to you?
Answered by Dr. Prasad 2 hours later
Brief Answer: I concur with his analysis... Detailed Answer: I am glad you visited a hematologist who knows you very well. It avoids undue investigations. I agree with the doctors opinion. Laboratory errors are known to happen sometimes. I did think of it before I started answering your question; but I decided not to reveal it as I feel it would be better to repeat the test after few weeks. The numbers should improve if it was from a recent infection or from the lab error. Moreover a board certified laboratory would always have a cross check mechanism before dispensing reports. You mentioned that neutrophil are also low along with the lymphocytes. This again is very common following recent infection. The term leukemia always brings on apprehension in all my patients. If blood reports don't improve, the doctor can order for peripheral smear, lymph node biopsy or a bone marrow aspiration to confirm the cancer. As your doctor has looked at the enlarged lymph node, he is likely to be right when he said it would not be a fast growing high grade cancer. Finally, I am happy that you found an able doctor who knows you very well. Further since he concluded it is not an aggressive pathology, I am not concerned about you any more. I wish you good health... Follow up with this doctor... Cheers!!
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Follow-up: What causes low Lymphocyte count? 2 hours later
I just wnted to correct something. I did first say the lymphocytes were too low, but that was wrong ghey are extremely high. They are supposed to be 2.4 and they are 87. Neutrophils are too lw
Answered by Dr. Prasad 1 hour later
Brief Answer: Numbers in in lines with your hematologist opinion Detailed Answer: Hi, I am sorry, I overlooked the number you posted in the follow up. Now the high lymphocytes with low neutrophil are in lines with the hematologist analysis. Drugs and stressors are sometimes linked with low lymphocyte count. A high value is common to both infection and cancer. The picture would be more clear after the follow up blood test. And as your doctor is not worried about high grade aggressive cancer, I think you should stop worrying. Hope this helped you. Feel free to discuss further and clarify before closing this discussion. Regards
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