Leukopenia Differential Diagnosis
The differential diagnosis for leukopenia can be organized into the following categories:
- Single Most Likely Diagnosis
- Viral infections (e.g., influenza, HIV, or hepatitis): These infections are common and can cause leukopenia due to bone marrow suppression or immune system dysregulation.
- Other Likely Diagnoses
- Bacterial infections (e.g., sepsis or tuberculosis): Severe bacterial infections can lead to leukopenia, especially if the bone marrow is affected or if there is significant immune system activation.
- Medication-induced leukopenia (e.g., chemotherapy, antibiotics, or anticonvulsants): Many medications can cause leukopenia as a side effect, either by suppressing bone marrow function or by inducing an immune response against white blood cells.
- Autoimmune disorders (e.g., lupus or rheumatoid arthritis): Some autoimmune conditions can lead to leukopenia due to the production of autoantibodies against white blood cells.
- Nutritional deficiencies (e.g., vitamin B12 or folate deficiency): Deficiencies in certain nutrients can impair bone marrow function, leading to leukopenia.
- Do Not Miss Diagnoses
- Aplastic anemia: A rare but potentially life-threatening condition where the bone marrow fails to produce blood cells, including white blood cells.
- Leukemia or lymphoma: Malignancies of the blood or lymphatic system can cause leukopenia, and early diagnosis is crucial for effective treatment.
- Sepsis or severe infection: While not always the most likely diagnosis, sepsis or severe infection can be life-threatening and requires prompt recognition and treatment.
- Rare Diagnoses
- Congenital disorders (e.g., Kostmann syndrome or Shwachman-Diamond syndrome): Rare genetic conditions that affect bone marrow function and can lead to leukopenia.
- Myelodysplastic syndromes: A group of disorders characterized by abnormal bone marrow function, which can cause leukopenia.
- Hairy cell leukemia: A rare type of cancer that can cause leukopenia due to bone marrow infiltration.
- Paroxysmal nocturnal hemoglobinuria (PNH): A rare disorder characterized by the destruction of red blood cells and can also lead to leukopenia.
A thorough workup for leukopenia should include a complete blood count (CBC) with differential, blood smear, bone marrow biopsy or aspiration, and testing for underlying infections, autoimmune disorders, or nutritional deficiencies.