Low lymphocytes can be caused by a minor infection, but it can be caused severe life threatening diseases HIV, Hodgkin’s disease, leukemia, etc. Low lymphocyte count is also known as lymphocytopenia. Having a low lymphocyte count can be really detrimental to your health as it can reduce your immunity levels and your ability to fight with various disease causing microbes. In this article, we shall discuss all the causes, symptoms, diagnosis and treatment of low lymphocyte count or lymphocytopenia.

What are lymphocytes?

In our blood, there are many different types of cells like WBC’S or white blood cells, RBC’s or Red blood cells and platelets. WBC’s are again divided into many different cell types, mainly granulocytes and the agranulocytes.

There are three types of granulocytes (the WBC’swhich contain granules). They are the eosinophils, basophils and the neutrophils. There are 2 types of agranulocytes. They are the monocytes and the Lymphocytes. All these blood cells are produced in the bone marrow which is inside our bones.

There is a system called lymphatic system in our body which includes the spleen, thymus, lymph nodes and lymph vessels. A fluid called lymph flows through the lymphatic vessels and it supplies all the parts of the body. Whenever there is any infection this WBC’s which are in the lymph help to fight the infection. Lymphocytes are the main cells present in the lymph or lymphatic fluid.

Types of lymphocytes:

You have learned that lymphocytes are a type of WBC’s and particularly agranulocytes. They help in fighting infections. But, do you know that there are 3 types of lymphocytes? The 3 types of lymphocytes are:

• B lymphocytes
• T lymphocytes
• Natural killer cells or NK cells

T lymphocytes:

Their full form is Thymus cells. The majority of lymphocytes (about 75% of them) enter the thymus gland and become T lymphocytes. They are responsible for the cell mediated immunity in our body. Again there are 3 types of T lymphocytes. There are helper T cells which recognize the pathogen or microbe and secrete substances called cytokines.

The Cytotoxic T cells or lymphocytes identify these cytokines  (cytokines act as signaling molecules), come to the pathogen and release toxic enzymes to kill the pathogen. There are also memory T cells which remember the pathogen or microbe and help to fight it in the future if any attack of the same organism happens.

B lymphocytes:

Their full form is the Bone marrow or Bursa derived lymphocytes. Some lymphocytes remain in the bone marrow itself and become B lymphocytes. They form an integral part of humoral immunity in our body. In Humoral immunity, our B lymphocytes produce many antibodies. These antibodies recognize the foreign antigen, for example, the microbe and go and attach to them and neutralize them. B cells also have memory cells which remember the antigens on the microbe and help protect our body from them in the future.

Natural killer cells:

Natural killer cells protect our body from a tumor or cancerous cells and the cells infected with viruses. They identify these cells and try to kill them by releasing toxic enzymes.

What is low lymphocyte count or what does low lymphocytes mean?

You have learned about the different types of lymphocytes. You also know that low lymphocyte count can be dangerous for our body. But, do you what exactly is low lymphocyte count? The normal lymphocyte count in healthy individuals is 1000 to 4800 lymphocytes per microliter or μl of blood.

Low lymphocyte count or lymphocytopenia is defined as the number of lymphocytes in the blood being less than 1000 per microliter or μl of blood.

Causes of low lymphocytes count:

There are many causes of Low Lymphocytes Count. Some are present from the time of birth as there are due to hereditary or inherited causes. Some people develop low lymphocytes count later on in life due to certain temporary illnesses and also due to serious disorders. Let us explore what causes low lymphocytes count in detail.

The main mechanism of having low lymphocytes count in the blood is due to:

• Decreased production of lymphocytes from the bone marrow is one of the main reason.
• The lymphocytes are produced in sufficient numbers just like in the normal people, but they are destroyed by external factors leading to low levels of lymphocytes.
• Sometimes lymphocytes can remain struck inside the organs of the lymphatic system like spleen and lymph nodes and unable to get out from there. Eventually, there are damaged in those parts. Due to them getting trapped in these parts, the levels of lymphocytes in the blood remains low.

Whatever the mechanism of having low lymphocytes in the blood, many different causes lead to one of the following mechanisms and ultimately to low lymphocytes count in the blood. Now, let us talk about the exact causes of low lymphocyte counts.

Hereditary causes:

Some people get this tendency to have low levels of lymphocytes in the blood from their birth. It is acquired from their parents who also might suffer from this condition or it might be hidden trait in their parents which get activated in the kids. Some examples of hereditary disorders leading to low levels of lymphocytes in the blood are:

DiGeorge syndrome:

It is caused by deletion of some parts of the 22nd chromosome. In addition to having low lymphocytes count, these people suffer from many other problems like heart ailments, learning disorders, problems with development, hearing disorders, developing many other autoimmune diseases, etc.

Wiskott Aldrich syndrome:

It is an X linked recessive disorder (a disorder which can be transmitted from your mother if your maternal uncle or mothers brother has the disorder). In this condition, in addition to low lymphocytes count, there is also a decreased number of platelets. They cannot form blood clots, so they suffer from bloody diarrhea, bleeding from the nose, etc. They also develop eczema.

Ataxia telangiectasia:

This is another disorder in which there are low lymphocytes right from birth. It is an autosomal recessive disorder, so it’s acquired from your grandparents. It can affect your brain, especially your cerebellum and cause severe disability. You cannot fight infections due to having low levels of lymphocytes. You can also have increased risk of cancer due to this disease.

Severe combined immunodeficiency:

In this condition, there is impairment of both B and t lymphocytes. So they have low lymphocyte counts of both the types of lymphocytes. They have very impaired immunity which puts them at risk of several infections. There are many subtypes of this disorder.

Acquired causes of low lymphocytes count:

We have seen the hereditary or inherited causes of low lymphocytes. Let us discuss the acquired causes of low lymphocytes count.

Rheumatoid arthritis:

It is an autoimmune disorder in which antibodies are produced against our own joints. These people suffer from severe joint pains in different parts of the body. They can also have low lymphocytes count.

Corticosteroid therapy:

Steroids or corticosteroids are given as treatment for several conditions as they possess anti-inflammatory properties. But, they do have their own side effects when given for long term. Developing low lymphocytes count is one of the side effects of long term use of steroids.

Hodgkin’s lymphoma:

Hodgkin’s lymphoma is a type of lymphoma or blood cell cancer or blood cancer. In this condition, low lymphocytes count can be present. It has many symptoms like fever, night sweats, having sudden weight loss, enlargement of lymph nodes in various parts of the body, etc.

Aplastic anemia:

In this condition, there is decreased the production of all types of blood cells from the bone marrow. In aplastic anemia, there is a decreased number of all types of WBC’s including lymphocytes, decreased coub\nts of RBC’s and also platelets.

Other causes of low lymphocytes count are as follows:

• Typhoid
• HIV infection
• Hepatitis (various types of Hepatitis like Hepatitis A, B, C, D, E)
• Treatments that were given for curing cancer or carcinoma (like radiation therapy and chemotherapy with various drugs)
• Bacterial infections
• TB or Tuberculosis of lungs (mainly Miliary Tuberculosis) or other regions
• Severe physical stress
• Fasting or not taking food for a long time
• Autoimmune disorders like SLE or systemic lupus erythematosus and Myasthenia gravis

Symptoms of low lymphocytes count:

There are various symptoms of low lymphocytes count. Let us look at some of them below.

• Fever, cold or coryza or a runny nose and cough- which can be due to the virus infecting your respiratory passages.
• Very small size of lymph nodes-which suggests a hereditary immune disorder
• Enlargement of lymph nodes-which suggests serious infections like AIDS and cancer or carcinoma
• Severe pain in various joints-This can suggest you are suffering from certain autoimmune disorders like Rheumatoid arthritis or SLE
• Increased susceptibility to various bacterial, viral and fungal infections due to low immunity levels.

Diagnosis of low lymphocytes count:

Having low lymphocytes count can be known by performing CBP or complete blood count. It is also called FBC or full blood picture. As we have already discussed the normal range of lymphocytes is 1000 to 4800 per microliter of blood. The lymphocytes form more than 20% and sometimes up to 40% of the total number of WBC’s.

If the number of lymphocytes is less than this, we can diagnose low lymphocytes count or lymphocytopenia. But, generally, in most CBP reports, the number of lymphocytes is given as a percentage. So, you can multiply this percentage by the total number of WBC’s to get the exact number of lymphocytes in the blood.

Treatment of low lymphocytes count:

Treatment of low lymphocyte counts depends on the cause of your disorder. When a doctor finds low lymphocyte counts in your blood, he might take a detailed history and order further laboratory tests to know the cause of your disease.

Based on the diagnosis of your disease, you will be treated. If you are suffering from any genetic disorder, you will need bone marrow replacement. If you are having low lymphocytes count due to drugs like steroids, cessation or stopping of steroids will correct the problem eventually. If you are suffering from a medical disorder like SLE or Rheumatoid arthritis or Myasthenia Gravis, you will be treated for that.

If you are suffering from low lymphocytes count due to bacterial infections, you will be given antibiotics. For example, if you are suffering from Typhoid or Tuberculosis, treatment of these infections with appropriate antibiotics will help to get back your lymphocytes count to a normal level.

I hope you have understood the causes, symptoms, diagnosis, and treatment of low lymphocytes count through this article. Let’s see you in another informative article about your health.

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