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Leukopenia

Leukopenia is a decrease in the number of leukocytes in the blood (less than 5000-4000). Leukopenia occurs in typhoid fever , brucellosis , influenza, polio , epidemic hepatitis, malaria, leishmaniasis, as well as radiation injuries (see Radiation damage), aleukia, aplastic and pernicious anemia. Leukopenia occurs from taking certain medications ( amidopyrine , butadione, sulfa drugs , methylthiouracil) in people with increased sensitivity to them. The most common form of leukopenia is neutropenia, including agranulocytosis (see), less frequently lymphocytopenia.

Leukopenia (leukopenia; from the Greek. Leukos - white and penia - poverty, lack) - a decrease in the number of leukocytes below 4000 in 1 mm 3 of peripheral blood. Leukopenia can proceed with a uniform decrease in all forms of leukocytes, however more often one form of white blood cells is reduced, which gives grounds to speak of neutropenia, lymphocytopenia, eosinopenia.

Leukopenia can be functional and organic. In functional leukopenia, the bone marrow is complete in its cellular composition, but functionally depressed. Organic leukopenia is due to cellular bone marrow failure due to the hypoplasia of the granulocyte bone marrow sprout, as well as its aplasia with the almost complete disappearance of myeloid elements.

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Functional leukopenias occur in hypnotic states, general decline in tone, irritation of the vagus nerve, fasting, shock states, as well as in acute and chronic infections (influenza, typhoid fever, measles, rubella, epidemic hepatitis, tuberculosis, syphilis, chronic osepsis, brucellosis, etc.). ); as a result of toxic effects on the blood (leukocytes) and hematopoietic organs of industrial substances (benzene, sodium fluoride, DDT preparations, etc.), as well as drugs (amidopyrine, butadione, antipyrine, 6-methylthio-uracil, etc.). The group of functional leukopenias should include deficient leukopenia, developing with alimentary dystrophy, insufficient intake of high-grade proteins, some amino acids, vitamins, etc., and immune leukopenia, depending on the presence of autoimmune antibodies in the blood and the development of leuko-agglutination and leukolysis.

The origin of leukopenias can be explained by a decrease in leukocyte production due to impaired differentiation, maturation and release of myeloid elements from blood foci to peripheral blood, or increased destruction of leukocytes and their excretion from the body. A certain value in the destruction of leukocytes belongs to the spleen. In conditions of hypersplenism, “splenic” leukopenia often develops. It is necessary to mention radiation leukopenias as a result of exposure to ionizing radiation, as well as “redistributive” L, which is not accompanied by a change in leukocyte formula and a violation of leukopoiesis in the bone marrow. Leukopenias with more complex pathogenesis are possible when several mechanisms are involved in their development. When leukopenia is of organic origin, the prognosis is poor. Leukopenia as a manifestation of the functional state of peripheral blood may in some cases lead to an outcome in leukemoid reactions and be a precursor of acute leukemia.

Treatment of leukopenia of different origin is reduced to the elimination of harmful exogenous factors, to the stimulation of leukopoiesis (pentoxyl, steroid hormones), repeated blood transfusions, vitamin therapy (B6, B12, pantothenic and folic acids, nucleic acid). With appropriate evidence, the issue of splenectomy should be addressed. Recently, bone marrow autotransplantation has been mastered.