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Leukopenia

Leukopenia is a condition wherein the leukocyte count in the blood is low. Low WBC or White Blood Cells indicate decrease in disease fighting cells circulating in the blood. Some of the common causes for low WBC count:


Viral infections Any viral infections may disrupt bone marrow function for a short duration thus producing low counts of white blood cells. Infections like typhoid, influenza may lower the white blood cell count.

Congenital disorders may weaken bone marrow function, a WBC spectrum test can confirm any such congenital disorder.

Kostmann's syndrome is a congenital disorder wherein the neutrophil production is low.

Myelokathexis Neutrophils fail to enter the blood stream.

Infectious disease HIV destroys the WBC and leaves the person susceptible to infections.

Malnutrition

Vitamin or mineral deficiencies

Parasitic diseases

Autoimmune disorders may destroy white blood cells or bone marrow cells.

Aplastic anemia In this condition the bone marrow does not produce enough of any of the cells including white blood cells. This condition may set in all of a sudden or can develop and progress gradually. Few drugs, pregnancy, radiation therapy or chemotherapy can trigger this condition.

Lupus is an auto immune disease wherein the body fights with its own immune system thus destroying white blood cells.

Chemotherapy and radiation therapy are used to kill cancerous cells. They however destroy healthy white blood cells thus leaving the patient with low WBC count. This is one major reason why cancer patients are unable to fight diseases or infections in general.

Leukemia is a type of cancer wherein the body produces too many white blood cells that are abnormal. These white blood cells are not active white blood cells that can fight infections. People down with leukemia have low white blood cell count as their bone marrow is producing more of the abnormal white blood cells.

Cancer may also damage the bone marrow.

Hyperthyroidism An overactive thyroid can produce lower number of white blood cells. The medication used for thyroid can reduce the white blood cell count in the blood.

Liver disorder/Spleen disorder Hypersplenism, in which blood cells are destroyed prematurely by the spleen. An enlarged spleen also known as splenomegaly can trigger low white blood cell count.

Leukemia

Leukemia is cancer of the white blood cells found in the blood. This serious disease is often fatal. Leukemia is caused due to either of the 2 abnormal white blood cells:

  • Myeloid white blood cells are made in the bone marrow from where they travel through the bloodstream destroying foreign organisms.
  • Lymphoid white blood cells are located in the lymph nodes and lymphatic system.
    Chronic leukemia is a situation where the disease progresses slowly. Acute leukemia is indicated by a sudden onset and is more likely to affect children and young people.

A person suffering from leukemia noticed repeated infections and unexplained bruising. There is a tendency to feel fatigued and anemic. Other symptoms include loss of weight and fever. Aching joints and bones are yet another symptom of leukemia. Symptoms of acute lymphoblastic leukemia appear very rapidly. A detailed blood test is taken for diagnosing leukemia. When it shows an abnormal number of abnormal white blood cells, it is indicative of leukemia. A bone marrow biopsy is taken to help classify the leukemia.


Treatment for leukemia includes radiotherapy, chemotherapy, immune therapy and bone marrow transplantation. Chemotherapy treatment uses cytotoxic drugs to kill abnormal cells thereby stopping their further division. But the fallout of this procedure is that often normal body cells such as those in the hair and skin are also killed. Bone marrow transplant is carried out only on children and younger patients. Marrow cells from a donor, who is generally a sibling, is replaced in the patient.



Pyuria

The medical term for cloudy, frothy and foul smelling pus in the urine is pyuria. It means the presence of significantly elevated level of white blood cells (leukocytes) in urine. White blood cells work with the immune system to defend against infectious diseases. A small number of white blood cells are normally present in the urine. But elevated levels indicate urinary tract problems signaling possible damage to the kidneys, ureters, urethra or bladder, inflammation or a contaminant.


Pyuria symptoms

Pyuria can be symptomatic or asymptomatic. Pyuria due to bacterial infection is symptomatic unless partially treated. Pyuria is asymptomatic when related to chronic infection from tuberculosis or mycoplasma, long-time indwelling catheters, inflammatory conditions like hemorrhagic cystitis, tubulointerstital nephritis or chronic prostatitis in men, or a contaminant such as vaginal secretions, vaginitis, cystocele etc. Asymptomatic pyuria goes away on its own, even without treatment.


  • Cloudy or milky urine
  • Foul-smelling urine
  • Frequent urgent need to urinate
  • Discomfort when urinating
  • Fever

Time to test

The test is done when individuals notice symptoms and seek medical attention. A physical examination is followed by laboratory urine test for pyuria urinalysis. If the test indicates pyuria, a culture of urine is suggested to detect the strain of bacteria that causes pyuria. To detect kidney abnormalities or infection, an intravenous pyelogram or ultrasound imaging of kidney is done. The presence of more than 3-5 white blood cells per high power field in the spun urine confirms pyuria.


Pyuria Causes

Urinary tract infection: The chance of urinary tract infection is high in men and women who are diabetic. As the urethra in women is comparatively shorter than men, it is easier for microorganisms to enter the female urinary tract and cause infection which increases the chance of women contracting urinary tract infection.

Sexually transmitted diseases: Men and women with sexually transmitted diseases are prone to pyuria.

Other causes: Other causes can be infectious or non-infectious.


  • Viral infection
  • Fungal infection
  • Anaerobic infection
  • Fastidious bacteria
  • Infection in prostate glands in men
  • Chemical poisoning
  • Kidney Stones
  • Tuberculosis of the urinary tract
  • Cancer of the urinary organs or genital organs

Non infectious: Medications, advanced age, pregnancy, tumors either benign or malignant can cause pus in the urine. Any other underlying problem in the kidney can also result in excessive levels of white cells in the urine.


Pyuria Treatment

The cause for pyuria determines treatment. For urinary tract infections, doctors prescribe antibiotic medicines. If the cause is due to sexually transmitted diseases, hygiene and other precautionary measures is recommended. Drinking plenty of water, juices sans sugar, avoiding fried foods, practicing good hygiene, not delaying for too long the urgency to urinate are proven precautionary measures of pyuria.


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Bibliography / Reference

Collection of Pages - Last revised Date: November 11, 2019