Low lymphocytes count

[Tired]

Prior to immunosupressive medication, I had normal lymphocyte counts. Now I have disconstinued immunosupressive medication for 3 years and my lymphocytes are still low. Either immunosupressive medication did irreversible damage or it is my Crohns. Wondering if others have a similar problem.

 

[kiny]

I have T lymphopenia.

You got your CD4/8 and B cells tested?

 

[kiny]

Need to go for a bit, if you have severe low lymphocytes, you need to get your CD4, CD8, CD45, your B cells, and your NK cells checked in your blood.

You should also get tested for HIV if needed, and for EBV.

If it's ideopathic, the standard treatment is the same as people with HIV, preventive trimethoprim to avoid lung infections and if suspected, azithromycin for mycobacterial infection.

Good luck.

 

[Tired]

I didn't do those tests, and my lymphopenia is not extremely low. I am just wondering if either it's the Crohn or immunosupressive therapy having damaged my bone marrow.

 

[kiny]

They won't damage your bone marrow. But what causes ideopathic lymphopenia is unclear. Most people recover from steroids and aza, some take months or years, some never do. why, they don't know, that's why it's called ideopathic

It's especially CD8 T cells that have a hard time recovering. in some people they don't recover. if it's related to drugs it's called drug induced lymphopenia

 

[Tired]

They won't damage your bone marrow. But what causes ideopathic lymphopenia is unclear. Most people recover from steroids and aza, some take months or years, some never do. why, they don't know, that's why it's called ideopathic

It's especially CD8 T cells that have a hard time recovering. in some people they don't recover. if it's related to drugs it's called drug induced lymphopenia

I'm supposed to start humira, I'm just afraid that the immunosupressors did a damage and that might increase my risk of lymphoma if I take humira.

 

[kiny]

I'm supposed to start humira, I'm just afraid that the immunosupressors did a damage and that might increase my risk of lymphoma if I take humira.

Well, that's something you will need to decide with an immunologist. You can't let your disease run wild either.

They actually don't have many studies on this, because as so happens, crohn's disease is extremely rare in AIDS patients.

But......I don't even know which lymphocytes are low with you. It could be B cells or T cells or NK cells. It all depends. People with AIDS have low CD4 for excample, but can have normal CD8. But people with lymphopenia tend to have both low CD4 and low CD8 and often also low CD45+, but they tend to stay stable, while people with AIDS keep dropping.

Lymphopenia in AIDS patients is caused by the HIV virus, why it happens in other people isn't really known. They're often referred to as non-HIV immunodeficiencies, ideopathic lymphopenia, and once serum has been tested it's either called B lymphopenia or T lymphopenia.

 

[kiny]

Also, if this makes you feel any better, people with AIDS often get cancer, but for people with lymphopenia it's often infections. Also, stress and diet (long-term calorie restricted diets, seen in anorexia and Africa) might be related to low lymphocytes...when people with HIV or HIV/AIDS get diagnosed with AIDS, their lymphocytes tend to drop even more. Why this happens they're not sure, but it might be the diagnosis contributing to decreased lymphocytes because of stress.

 

[kiny]

I would suggest doing a specific lymphocyte blood test instead of an absolute, if it bothers you, they're usually not done in people with crohn's disease, but they are commonly performed in people with AIDS and people with lymphopenia. It will tell you if it's a T or B cell issue. You can always ask for an HIV test too, it just a blood test, and it's completely accurate.

Also, it's always possible you have some kind of infection too, although 3 years is a pretty long time. Regardless make sure you get checked out regularly, even if it's ideopathic, an infection would make it worse.