How to treat low white blood cell count? Treatment of the cause is the most important

Low white blood cell count generally does not show any obvious symptoms. If the low white blood cell count is severe, symptoms such as dizziness, loss of appetite, and fatigue will appear. The treatment of low white blood cell count must be targeted at the cause, and timely treatment of viral infections is the most important.

1. Etiological treatment

Contact with suspected drugs or other pathogenic factors should be stopped immediately. Patients with secondary reduction should actively treat the primary disease. After the treatment of acute leukemia, autoimmune diseases, infections, etc., the granulocytes can return to normal after the condition is alleviated or controlled. Splenectomy may be considered for patients with hypersplenism.

2. Prevent and treat infection

No special precautions are required for mild reductions. The infection rate increases in those with moderate reduction, so they should reduce going to public places, pay attention to maintaining skin and oral hygiene, and remove chronic infection lesions. For patients with granulocytopenia, sterile isolation measures should be considered to prevent cross infection. Infected persons should undergo bacterial culture and drug sensitivity testing of blood, urine, sputum and secretions of infected lesions, as well as imaging examinations to determine the type and location of infection. Before the pathogen is identified, broad-spectrum antibiotics can be used empirically to cover both Gram-negative and Gram-positive bacteria, and the medication can be adjusted after the pathogen and drug sensitivity results are available. If it is ineffective after 3 to 5 days, antifungal treatment can be added. Antiviral drugs can be added for viral infections.

3. Granulocyte-enhancing drugs

Hematopoietic growth factors, such as recombinant human granulocyte colony-stimulating factor (rhG-CSF) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF), have a clear efficacy in treating patients with granulocytosis. They can rapidly increase the number of neutrophils and enhance their phagocytic, bactericidal and chemotactic functions. The commonly used dose is 2~10ug/(kg·d). Common side effects include fever, musculoskeletal pain, rash, etc.

Lithium carbonate can stimulate the bone marrow to produce granulocytes. The commonly used dosage is 0.6-0.9g/d. The side effects include mild heartburn, nausea, fatigue, etc. It should be used with caution in patients with kidney disease.

4. Immunosuppressants

Autoimmune neutropenia and agranulocytosis caused by immune-mediated mechanisms can be treated with immunosuppressants such as corticosteroids. It is not suitable for patients with granulocytopenia caused by other reasons. [2]