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Differential Diagnosis: Lymphopenia

Julie Allen, BVMS, MS, MRCVS, DACVIM (SAIM), DACVP, Cornell University

Internal Medicine

|August 2020|Peer Reviewed

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Differential Diagnosis: Lymphopenia

Following are differential diagnoses for patients presented with lymphopenia.

  • Acute infection, particularly viral 
  • Cytotoxic or immunosuppressive drug (eg, chlorambucil, cyclophosphamide) 
  • Destruction/disruption of lymphoid tissue (eg, multicentric lymphoma)
  • Immunodeficiency (rare; eg, severe combined immunodeficiency syndrome in basset hounds, Cardigan Welsh corgis, Jack Russell terriers, Frisian water dogs)
  • Increased exposure to endogenous corticosteroids
    • Acute illness
    • Hyperadrenocorticism
    • Stress (eg, surgery)
  • Increased exposure to exogenous corticosteroids
    • Steroid therapy
    • Contact with steroid creams in household
  • Loss of lymphocytes (eg, into intestinal tract with lymphangiectasia, into pleural cavity with chylothorax)
  • Whole body irradiation


For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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