HNY Policy and Pathway Repository - York

Low lymphocyte count. This is usually a benign situation.

None

There are numerous causes of a low lymphocyte count. If one or more of these is known to be present, then no further investigation is required:

• Elderly patients (>70 years old and lymphocytes >0.5)
• Reactive and post acute infections, trauma, surgery, stress
• Bacterial and viral infection including HIV, hepatitis, TB
• Systemic autoimmune disorders
• Medications including steroids, chemotherapy, rituximab
• Sarcoidosis
• Alcohol excess
• Malnutrition
• Systemic illness (renal, cardiac, liver failure, malignancy)
• Rare congenital immune disorders

Even in the absence of one of these causes, if the lymphocytopenia is mild (0.5-1.5) and the patient is well, then only FBC monitoring is required (eg 6 monthly initially, extended to annually if stable)

 

Only refer to haematology if there are other factors raising concern for haematological malignancy:

• Unintentional weight loss
• Fevers in the absence of infection
• Drenching night sweats
• Recurrent infections with no other underlying cause
• Lymphadenopathy or hepatosplenomegaly
• Other cytopenias

None provided