Leukopenie – ein diagnostischer Leitfaden für die Praxis

Abstract

Reasons for leukopenia can be numerous. To get close to the diagnosis it’s always useful to check previous blood counts of the patient to get a feeling for the dynamic development of the leukopenia. Furthermore, it’s important to check the red blood cell count and platelet count as well; a bi- or a pancytopenia usually implies an insufficient production in the bone marrow. Nevertheless, a manual counted peripheral blood smear is an essential step towards the right diagnosis in leukopenia: Beside cell counts of the single subgroups of leucocytes it also provides information on potential causes such as dysplasia.

Leukopenia can be life-threatening for the patient especially if the patient presents with an agranulocytosis and fever: In this case admission is mandatory and the patient has to be treated immediately with broad-spectrum antibiotics to reduce mortality.

Eine neu aufgetretene Leukopenie sollte grundsätzlich weiter abgeklärt werden. Die Ursachen können vielfältig sein. Einfache diagnostische Mittel wie eine ausführliche Anamnese, körperliche Untersuchung und ein manuell ausgezähltes Differenzialblutbild können für die Differenzialdiagnostik und Therapie bereits wegweisend sein. Hilfreich ist dabei das Vorgehen nach einem diagnostischen Algorithmus.

Schlüsselwörter

Leukopenie - Neutropenie - Differenzialblutbild - Vitamin-B₁₂-Mangel

Key words

leukopenia - neutropenia - peripheral blood smear - vitamin B₁₂ deficiency

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