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Hematologist, oncohematologist

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The causes of increase and decrease of lymphocytes

Alexey Portnov, medical expert
Last reviewed: 19.10.2021

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Absolute lymphocytosis (increase in lymphocytes): the absolute number of lymphocytes in the blood exceeds 4 × 10 ⁹ / L in adults, 9 × 10 ⁹ / L in young children and 8 × 10 ⁹ / L in older children.

In clinical practice, lymphocytes are elevated in leukemoid reactions of the lymphatic type, when the blood picture resembles that of acute or chronic leukemia. Lakemoid reactions of the lymphatic type most often develop with infectious mononucleosis, but sometimes also are possible with tuberculosis, syphilis, brucellosis. The blood picture in acute infectious mononucleosis is characterized by high leukocytosis due to lymphocytes. Lymphocytes in infectious mononucleosis acquire morphological diversity. A large number of atypical lymphocytes, characterized by dysplasia of the nucleus and an increase in the cytoplasm and acquiring a similarity to monocytes, appear in the blood.

Absolute lymphopenia (lowering of lymphocytes) - the number of lymphocytes in the blood less than 1 × 10 ⁹ / l - occurs with some acute infections and diseases. Lymphopenia (lymphocytes are lowered) in the initial stage of the infectious-toxic process, which is associated with the migration of lymphocytes from the blood in the tissue to the foci of inflammation.

Diseases and conditions accompanied by changes in lymphocyte content

Absolute lymphocytosis	Absolute lymphopenia
Viral infection	Pancytopenia
Acute infectious lymphocytosis	Admission of glucocorticosteroids
Whooping cough	Severe viral diseases
Infectious mononucleosis	Malignant neoplasms
Acute viral hepatitis	Secondary immunodeficiencies
CMV infection	Renal insufficiency
Chronic lymphatic leukemia	Insufficiency of blood circulation
Waldenström macroglobulinemia

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