Lymphocytopenia in a hospital population - What does it signify?
Lymphocytopenia in a hospital population - What does it signify?
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DOI：
10.1111/j.1445-5994.1997.tb00934.x
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发表时间：
1997-04-01
期刊：
影响因子：
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通讯作者：
Kay, TWH
中科院分区：
文献类型：
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作者：
Castelino, DJ;McNair, P;Kay, TWH
背景：淋巴细胞减少症是医院患者的常见症状，特别是自自动白细胞分类计数器出现以来，人们对淋巴细胞减少症的原因和意义普遍知之甚少。 25年来一直没有对其意义进行大规模研究。 HIV 流行和最近描述的特发性 CD4+ T 淋巴细胞减少症引起了人们对这一发现的兴趣。目的：描述到达医院的成人的淋巴细胞减少症谱并调查其临床意义。方法：使用可用的计算机设施，患有显着淋巴细胞减少症（1x10(9)/L）的患者。我们仅发现一名疑似特发性 CD4+ T 淋巴细胞减少症的患者。患者分为几类（有一些重叠）：细菌/真菌败血症（250 例）、术后（228 例）、皮质类固醇治疗（确定 159 例疑似 53 例，单独吸入类固醇 14 例），恶性肿瘤（174 例确诊，6 例可能）、细胞毒治疗和/或放射治疗（90）、创伤或出血（86）、移植（73-38 例肾移植和 35 例骨髓移植）、“病毒感染”（26 例）和 HIV 感染（13 例）。在研究期间，有 34 名患者死亡。结论：医院患者的淋巴细胞减少症通常是可逆的，尤其是由于急性疾病。脓毒症和外伤（包括手术），无论是否接受化疗，以及使用类固醇也是常见原因，但 HIV 感染在我们医院是相对不常见的原因。
Background: Lymphocytopenia is a common finding in hospital patients especially since the advent of automated differential leukocyte counters, The causes and significance of lymphocytopenia are generally poorly understood. There has been no large-scale study of its significance for 25 years. The HIV epidemic, and the recently described idiopathic CD4+ T-lymphocytopenia have raised interest in this finding.Aims: To describe the spectrum of lymphocytopenia in an adult reaching hospital and investigate its clinical significance. Methods: Using the available computer facilities, patients with significant lymphocytopenia (1x10(9)/L. We found only one patient who was suspected of having idiopathic CD4+ T-lymphocytopenia. Patients fell into several categories (with some overlap): bacterial/fungal sepsis (250), post-operative (228), corticosteroid therapy (definite 159 suspected 53, inhaled steroids alone 14), malignancy (174 definite, six probable), cytotoxic therapy and/or radiotherapy (90), trauma or haemorrhage (86), transplants (73-38 renal and 35 bone marrow), 'viral infections' (26) and HIV infection (13). Thirty-four patients died within the study period.Conclusions: Lymphocytopenia in hospital patients is mast frequently reversible, and due to acute illness, notably sepsis and trauma (including surgery). Malignancy, with or without chemotherapy, and steroid use are also common causes, but HIV infection is a relatively uncommon cause in our hospital.