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
- 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