Lymphopenia is a common finding, especially in elderly patients, where it is usually of no clinical significance. No further investigation is advised in elderly patients with a lymphocyte count >0.5X10?/Lin the absence of any concerning symptoms.

Most cases are reversible and do not require specialist evaluation

Common Causes:

  • Stress- such as acute infection or recent surgery
  • Medication- especially immunosuppressant drugs such as steroids

A full list of causes are listed in this BMJ guidance, together with recommendations for investigation in primary care: https://www.bmj.com/content/348/bmj.g1721

If unexplained moderate to severe lymphopenia (lymphocyte count <1 X10?/L) offer HIV test

Who to refer?

Symptomatic patients with persistent lymphopenia (>3months) should be referred to the most appropriate speciality based on clinical and laboratory features

Nb Persistent lymphopenia remaining stable over 6 month period, in the absence of symptoms, clinical findings or abnormal results from investigation does NOT require referral.



Dr Richard Noble, Consultant Haematologist, RCHT

Dr Bridgitte Wesson, GP & Kernow RMS Haematology guideline lead

Review date: 13/07/2020

Next Review due: 13/07/2021