Difference Between Leukocytosis and Leukopenia

Main Difference – Leukocytosis vs Leukopenia

Leukocytosis and Leucopenia are two terms in medicine which refer to an abnormality seen in white blood cells and doctors will often identify them by doing a complete blood count. The main difference between Leukocytosis and Leukopenia is that Leukocytosis is an increase in the number of white blood cells whereas Leukopenia is an abnormal reduction of white blood cells, giving rise to a significant immune-suppression.

In this article, we will discuss,

1. What is Blood?

2. What is Leukocytosis?
      – Types, Causes, Features, Signs and Symptoms, Treatment

3. What is Leukopenia?
     – Causes, Features, Signs and Symptoms, Treatment

4. Difference Between Leukocytosis and Leukopenia

What is Blood

The human body is a collection of systems which work as a network. Every system has its own function in order to maintain a healthy body. Blood is also a part of this network, but the difference between blood and other systems is that this exists in the form of fluid. Not only does blood act as the medium of transportation, but  it also has a major role in captivating an optimal state of protection from harmful substances.

An average adult has about 5 l of blood, which is made up of a portion of plasma (half) and cells (half) which are conducted via blood vessels. Arteries are the vessels that carry oxygenated blood to organs and veins are the ones that carry deoxygenated blood back to the heart. Blood is composed of

  • Red blood cells – Bind to oxygen and perfuse organs.
  • White blood cells – Part of the immune system which provides protection against harmful materials and infections
  • Platelets – Clotting of blood to prevent from excessive bleeding

Difference Between Leukocytosis and Leukopenia- infographic

What is Leukocytosis

Leukocytosis is an abnormality of blood, often identified by a complete blood count, which will reveal an overproduction of leukocytes (white blood cells). Being produced in the bone marrow, some of these cells will be released to blood whereas the rest will be stored in the marrow which is a spongy, soft tissue seen inside bones.

In general medicine, Leukocytosis is grouped into 5 subcategories based on the type of the white blood cells that increase in number.

  • Neutrophils
  • Eosinophils
  • Basophils
  • Monocytes
  • Lymphocytes

Difference Between Leukocytosis and Leukopenia

Leukocytosis can affect one or more of the above cell types, due to various etiological factors.

Causes of Leukocytosis

Usually, an increase of leukocytes in the body means, it is fighting against some sort of a harmful infection which can be bacterial, viral, fungal or parasitic in origin. It can also be due to,

  • Inflammation with redness, warmth, swelling and disability. Mostly seen in patients with Rheumatoid arthritis,  and regular arthritis
  • Tissue damage due to malignancy or burn
  • An allergy or asthmatic attack
  • Various prescribed medications such as anti-psychotics, anti-inflammatory, anti-cancer,
  • Health issues related to bone marrow such as Leukemia, thrombocytopenia, myelofibrosis
  • Physical or emotional stress
  • Tuberculosis, whooping cough, measles
  • Pregnancy

Signs and Symptoms of Leukocytosis

Most patients with Leukocytosis will not show any particular sign or symptom specific to the condition itself, but most of the time, all the features associated with the etiological condition will be observed on taking a clinical history and carrying out a thorough physical examination. Some of the commonest features noted in suspected individuals are as follows.

  • High fever
  • Easy bruising and bleeding
  • Weakness, lethargy and tiredness
  • Faintishness and dizziness
  • Tingling sensation in distal limbs
  • Breathing disturbances
  • Poor concentration
  • Loss of appetite and loss of weight

Treatment for Leukocytosis

As far as the treatment for Leukocytosis is concerned, it is always important to find the root cause of the condition rather than treating the patient targeting the symptoms.

If the elevation of leukocytes is due to some drug the patient is taking, it is mandatory to stop the drug and replace it with an alternative.

Some other key features of treatment include,

  • Intravenous fluids
  • Antibiotics to treat the infection if a bacterial etiology has been revealed.
  • Steroids to reduce inflammation
  • Anti-uric acid medication to reduce the uric acid which may get produced as a complication of leukocytosis thus damaging the cells left.
  • Leukocyte – reduction in order to slow down the production of white blood cells
  • Chemotherapy – to kill tumour cells
  • Blood transfusion
  • Bone marrow transplantation (this is the last option available if other treatments do not work)

What is Leukopenia

Leukopenia is a condition where a significant reduction of white blood cells is observed, which in turn weakens the immunity system, making the body vulnerable to get various infections one after the other.

Causes of Leukopenia

Commonest causes for Leukopenia includes,

  • Certain medications like steroids, antipsychotics, anti-epileptics, interferons
  • Malignancies-Lymphoma
  • Autoimmune conditions- Systemic lupus erythematosus (SLE)
  • Bone marrow diseases- Myelodysplastic syndrome, leukaemia, Myeloproliferative syndrome, myelofibrosis
  • Severe blood infection causing sepsis
  • Hypersplenism which causes a rapid destruction of functional white blood cells
  • Chemotherapy
  • Stem cell transplantation
  • Bone marrow transplantation

However, all these will ultimately result in an immunosuppression and therefore it is important to diagnose the possible etiology as soon as possible in order to prevent further complications.

Signs and Symptoms, Treatment and Management of Leukopenia

Patients with leukopenia will mostly complain of recurrent infections suggestive of poor immunity whereas other features will depend on the underlying medical condition.

While medications are working out appropriately on the etiological condition, the patient can be saved from further infections by ensuring a good hygiene, proper hand washing, avoiding contagious diseases, avoiding overcrowded places and using a nose and mouth mask if possible.

It is also important to check white blood cell levels routinely in order to see if the body is responding to drugs. Once the root cause is eliminated, the patient will recover soon.

Key Difference - Leukocytosis vs Leukopenia

Reference ranges for white blood cells.

Difference Between Leukocytosis and Leukopenia

White Blood Cell Level

Leukocytosis is an increase in the number of white blood cells whereas Leukopenia is an abnormal reduction of white blood cells, giving rise to a significant immune-suppression.

There can be several etiological conditions responsible for each of these findings and the treatment plan and follow-up will mainly depend on this etiology. In fact, once the root cause is eliminated fully, these abnormalities will eventually return to the normal range.

Image Courtesy:

“Blausen 0909 White Blood Cells” by Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. – Own work (CC BY 3.0) via Commons Wikimedia

“Reference ranges for blood tests – white blood cell” By Häggström, Mikael. “Medical gallery of Mikael Häggström 2014”. Wikiversity Journal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 20018762. – Own work (Public Domain) via Commons Wikimedia

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