What Viral Infections Cause Low White Blood Cell Count – Dear Mayo Clinic: My 16-year-old grandson was recently diagnosed with a low white blood cell count after going to the ER with migraine headaches, vomiting, and temporary vision loss. What could be the cause of low white blood cells at his age? I am concerned that this is something serious and am wondering what other tests should be done.

ANSWER: Many diseases and conditions can cause low white blood cells. Without more information it is difficult to say what the cause of your grandchild’s condition may be. A small number are unrelated to his migraines and other symptoms. It would be wise to have another blood test to see if the problem persists. His doctor can then decide if he needs further evaluation.

What Viral Infections Cause Low White Blood Cell Count

Blood has several components. In addition to white blood cells that fight infection, red blood cells carry oxygen and platelets help blood clot. Bone marrow, the spongy tissue inside bones, makes blood cells.

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There are several types of white blood cells. Neutrophils fight fungal and bacterial infections. Lymphocytes protect the body from viral infections. Monocytes help get rid of dead or damaged tissue and regulate the body’s immune response. Eosinophils are white blood cells that fight disease. Basophils play a role in wound healing, infection, and allergic reactions.

One of the most common causes of low white blood cell counts is a viral infection. These infections can sometimes temporarily disrupt the bone marrow’s production of blood cells, so the number of blood cells decreases. As the body recovers from the infection, the numbers usually rise. For most people, there are no long-term effects from a temporary drop in blood cells.

Some medications can also cause low white blood cells because they can destroy white blood cells or damage the bone marrow. For example, taking antibiotics can cause an abnormal decrease in neutrophils, a condition called neutropenia. With this in mind, it may be helpful to check with your child’s doctor about any medications he or she is taking to see if they can cause changes in his or her blood cell count.

Various conditions and disorders can also cause neutropenia. For an overview of this condition and more information on diagnosis and treatment, you can watch this Mayo Clinic video.

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The list of other causes of low white blood cell counts in a person is long. Autoimmune disorders, congenital disorders that affect bone marrow function, vascular disorders, certain infectious diseases, cancers, and parasitic diseases can all cause low white blood cell counts.

A good next step for your child is a complete blood count. This test measures components in the blood. This test can help determine what type of white blood cells your child has low, as well as what may be causing the low test results of other blood components.

The other symptoms you mention — headaches, vision loss, and vomiting — should also be addressed with a physical exam, a review of your grandchild’s family and medical history, and additional tests your doctor may recommend. Although these symptoms are not related to her low white blood cell count, it is important to investigate and determine the underlying cause. — Carola Arndt, pediatric hematology/oncology, Mayo Clinic, Rochester, Minn.

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Hand, foot, and mouth disease is usually caused by acoxsackievirus, a highly contagious disease of children. The virus can be spread through respiratory droplets, from person to person… For L), in non-pregnant adults, a common differential finding. It is important for clinicians to be able to differentiate between malignancy and other common causes of leukocytosis.

For L) is sometimes called a leukemoid reaction. These elevated levels may occur in some severe infections, such as Clostridium difficile infection, sepsis, organ rejection, or in patients with malignancies.

For L) at 12 h lifetime (95% confidence interval). By two weeks this drops to about 5,000 to 20,000 per mm

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There is also a shift from relative lymphocyte to neutrophil predominance from childhood to adolescence and adulthood.

A gradual increase in the normal WBC count is observed during pregnancy (3rd trimester 95% upper limit = 13 mm 200 mm)

L) after caesarean section. Of note, positive bacterial cultures were not associated with leukocytosis or neutrophilia, making leukocytosis an unreliable discriminator of whether postpartum patients require antibiotic therapy.

The life cycle of leukocytes includes growth and differentiation, storage in the bone marrow, intravascular differentiation, and migration into tissues. Stem cells in the bone marrow give rise to the cell line of erythroblasts, which develop into red blood cells; megakaryoblasts that develop into platelets; lymphoblasts; and myeloblasts. Lymphoblasts develop into various T and B cell lymphocytes. Myeloblasts differentiate into monocytes and granulocytes and contain neutrophils, basophils, and eosinophils (Figure 1). Once WBCs reach the bone marrow, 80% to 90% are retained in the bone marrow. This large reserve allows for a rapid increase in the number of circulating WBCs within hours. A relatively small pool of leukocytes (2% to 3%) circulates freely in the peripheral blood

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; the rest are located in the walls of blood vessels or in the vasculature. Leukocytes spend most of their lives in storage. After the leukocyte is released into the circulation and peripheral tissues, its life span ranges from two to 16 days, depending on the cell type.

Although the differential of the major types of WBC is important to evaluate the cause of leukocytosis, it is useful to think in absolute terms rather than relative, leukopenia and leukocytosis. To calculate the absolute cell count, the total leukocyte count is multiplied by the differential percentage. For example, a normal WBC count is 10 mmHg

For L) and a 12 percent increase in monocytes, an absolute monocyte count of 12% or 0.12 times per 10,000,000 mm of WBC count.

The most common type of leukocytosis is neutrophilia (an increase in the absolute number of mature neutrophils greater than 7,000,000 mm).

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Can arise from infections, stressful conditions, chronic inflammation, drug use, and other causes (Table 3).

Lymphocytosis (when lymphocytes make up more than 40% of the WBC count or when the absolute count is more than 4,500 per mm)

L]) can occur in patients with pertussis, syphilis, viral infections, allergic reactions, and certain types of leukemia or lymphoma. Lymphocytosis may be more common in children than in adults.

Epstein-Barr virus infection, tuberculosis or fungal diseases, autoimmune diseases, splenectomy, protozoan or rickettsial infections, and malignancy can cause monocytosis (monocytes make up more than 8% of the WBC count or an absolute count greater than 880 per mm

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(for L), although rarely, suggest allergic conditions such as asthma, urticaria, atopic dermatitis or eosinophilic esophagitis, drug reactions, dermatological conditions, cancer, connective tissue disease, idiopathic hypereosinophilic syndrome, or parasitic infections, including helminths (tissue parasites) can than intestinal-luminal parasites).

(for L) is rare and unlikely to cause leukocytosis in isolation, but it may occur with allergic or inflammatory conditions and chronic myelogenous leukemia.

For L), can arise from various etiologies. Any source of stress can cause catecholamine-demarginalization of WBCs, as well as increased removal from the bone marrow storage pool. Examples include surgery, exercise, trauma, burns, and emotional stress.

Medications known to increase the WBC count include corticosteroids, lithium, colony-stimulating factors, beta-agonists, and epinephrine. A reverse leukocytosis may occur during the recovery phase after blood transfusion or hemolysis.

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Leukocytosis is one of the signs of infection. During the acute phase of many bacterial infections, there are primarily mature and immature neutrophils (Figure 2); sometimes, as the infection progresses, there is a shift to lymphocyte predominance. The release of immature platelets and metamyelocytes into the peripheral circulation is referred to as a “left shift” in the WBC differential. Note that some bacterial infections paradoxically cause neutropenia, such as typhoid fever, rickettsial infections, brucellosis, and dengue.

A viral infection can cause leukocytosis early on, but persistent leukocytosis is uncommon, except for lymphocytosis in some childhood viral infections.

An elevated WBC count is a sign of significant infection, but is not definitive. For example, the sensitivity and specificity of the WBC count in the diagnosis of acute appendicitis are 62% and 75%, respectively.

The discriminatory value of leukocytosis is less than that of other biomarkers, such as C-reactive protein or procalcitonin, for the diagnosis of serious bacterial infections without a source in febrile children.

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(for L) is one of the criteria for systemic inflammatory syndrome (or sepsis)

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