{"id":688,"date":"2023-01-26T10:25:46","date_gmt":"2023-01-26T10:25:46","guid":{"rendered":"https:\/\/avo6.com\/?p=688"},"modified":"2023-01-26T10:50:44","modified_gmt":"2023-01-26T10:50:44","slug":"tout-ce-que-vous-devez-savoir-sur-la-lymphopenie","status":"publish","type":"post","link":"https:\/\/avo6.com\/?p=688","title":{"rendered":"Tout Ce Que Vous Devez Savoir Sur La Lymphop\u00e9nie"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"1000\" height=\"550\" src=\"https:\/\/avo6.com\/wp-content\/uploads\/2023\/01\/Lymphopenie-1000x550.jpeg\" alt=\"Lymphop\u00e9nie \" class=\"wp-image-693\" srcset=\"https:\/\/avo6.com\/wp-content\/uploads\/2023\/01\/Lymphopenie-1000x550.jpeg 1000w, https:\/\/avo6.com\/wp-content\/uploads\/2023\/01\/Lymphopenie-525x289.jpeg 525w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><\/div>\n\n\n<h2>INTRODUCTION<\/h2>\n\n\n\n<p>Une lymphop\u00e9nie est d\u00e9finit par un taux de lymphocytes total &lt;&nbsp;1 500\/ mm3 chez l&rsquo;adulte&nbsp; ou&nbsp; &lt;3000\/ mm3 chez&nbsp; l\u2019enfant. Elle peut concerner les lymphocytes B et\/ou les lymphocytes T ou une sous-population lymphocytaire (CD4;CD8).<\/p>\n\n\n\n<p>Sur le plan biologique, le diagnostic\u00a0 \u00e9tiologique sera conduit en fonction de la clinique et l\u2019h\u00e9mogramme.<\/p>\n\n\n\n<h2>CIRCONSTANCE DE DECOUVERTE\u00a0<\/h2>\n\n\n\n<ul><li>Pathologie pr\u00e9existante: Int\u00e9r\u00eat\u00a0 d\u2019un interrogatoire pr\u00e9cis: Age; ant\u00e9c\u00e9dent (ATCD), traitement<\/li><li>Manifestations cliniques d\u2019immunod\u00e9pression: Infections \u00e0 r\u00e9p\u00e9tition ; lymphad\u00e9nopathies ;\u00a0 l\u00e9sions dermatologiques<\/li><li>D\u00e9couverte fortuite: lors d\u2019un examen syst\u00e9mique<\/li><\/ul>\n\n\n\n<h2>DIAGNOSTIC AU LABORATOIRE<\/h2>\n\n\n\n<p><strong>Un interrogatoire<\/strong> est indispensable pour rechercher des ATCD :<\/p>\n\n\n\n<ul><li>Pathologie : n\u00e9oplasie; maladie syst\u00e8me<\/li><li>Traitement : chimioth\u00e9rapie; radioth\u00e9rapie<\/li><li>Notions d&rsquo;infections r\u00e9p\u00e9t\u00e9es, inhabituelles<\/li><li>Facteurs de risque d\u2019infection VIH<\/li><\/ul>\n\n\n\n<p><strong>L\u2019examen clinique<\/strong> recherche<\/p>\n\n\n\n<ul><li>Un syndrome tumoral : (ad\u00e9nopathie (ADP) ; spl\u00e9nom\u00e9galie (SMG) orientant vers des\u00a0 h\u00e9mopathies lympho\u00efdes.<\/li><li>Des signes rhumatologique : orientant vers une maladie de syst\u00e8me.<\/li><li>Un syndrome polymalformatif chez l\u2019enfant orientant vers un d\u00e9ficit immunitaire constitutionnel.<\/li><\/ul>\n\n\n\n<p><strong>L\u2019examen paraclinique<\/strong> d\u00e9pend de l\u2019orientation clinique&nbsp;:S\u00e9rologie VIH, bilan immunologique, ph\u00e9notypage lymphocytaire.<\/p>\n\n\n\n<p><strong>H\u00e9mogramme<\/strong>: Taux lymphocytes : &lt;&nbsp;1 500\/ml&nbsp; chez l&rsquo;adulte&nbsp; ou&nbsp; &lt;3000\/ml chez&nbsp; l\u2019enfant.<\/p>\n\n\n\n<p>&nbsp;Il faut contr\u00f4ler&nbsp; h\u00e9mogrammes anciens pour d\u00e9terminer si lymphop\u00e9nie :<\/p>\n\n\n\n<ul><li>isol\u00e9e \/ associ\u00e9e \u00e0 cytop\u00e9nie<ul><li>r\u00e9cente \/ ancienne<\/li><\/ul><ul><li>stable\/ s\u2019aggrave<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong>Frottis sanguin<\/strong>&nbsp;: V\u00e9rifie la r\u00e9alit\u00e9 de la lymphop\u00e9nie: pseudo-agglutination des lymphocytes due \u00e0 l&rsquo;EDTA et rechercher d\u2019\u00e9ventuelles anomalies morphologiques&nbsp;<\/p>\n\n\n\n<p><strong>Cytom\u00e9trie en flux<\/strong>\u00a0: Mesure des sous-populations lymphocytaires CD4 ; CD8<\/p>\n\n\n\n<h2>DIAGNOSTIC DE GRAVITE\u00a0<\/h2>\n\n\n\n<p>Le risque infectieux: d\u00e9pend du taux de lymphocyte CD4:<\/p>\n\n\n\n<p>En g\u00e9n\u00e9ral celui-ci appara\u00eet si le taux de CD4 &lt; 0,3 &#8211; 0,4 G\/L avec un rapport CD4\/CD8 &lt; 1.0<\/p>\n\n\n\n<p>Une lymphop\u00e9nie CD4 profonde (&lt; 100 voir a 50 \/mm\u00b3) est \u00e9troitement\u00a0 associ\u00e9e aux autres infections opportunistes.<\/p>\n\n\n\n<h2>DIAGNOSTIC ETIOLOGIQUE<\/h2>\n\n\n\n<h3>1. <strong>Lymphop\u00e9nie au cours infection HIV<\/strong><\/h3>\n\n\n\n<p>La d\u00e9pl\u00e9tion progressive en lymphocytes TCD4+, marqueur pronostique essentiel de la maladie, constitue la principale manifestation immunopathologique induite par l\u2019infection HIV.<\/p>\n\n\n\n<h3>2. <strong>Lymphop\u00e9nie des d\u00e9ficits immunitaires cong\u00e9nitaux<\/strong><\/h3>\n\n\n\n<ul><li>Aplasie des cellules souches lympho\u00efdes<\/li><li>Syndrome de d\u00e9ficit immunitaire combin\u00e9 s\u00e9v\u00e8re<\/li><li>Immunodeficit avec thymome<\/li><li>Lymphocytop\u00e9nie Idiopathique T Cd4<\/li><\/ul>\n\n\n\n<h3>3. <strong>Lymphop\u00e9nie infectieuse:<\/strong><\/h3>\n\n\n\n<p>Processus septique grave, Forme maligne de la fi\u00e8vre typho\u00efde, Tuberculose, infections \u00e0 cytom\u00e9galovirus, rougeole, acc\u00e8s palustre.<\/p>\n\n\n\n<h3>4. <strong>Lymphop\u00e9nie toxique<\/strong><\/h3>\n\n\n\n<p>Immunosuppresseurs, <a href=\"https:\/\/avo6.com\/?p=45\">Chimioth\u00e9rapie<\/a>, Radioth\u00e9rapie, S\u00e9rum antilymphocytaire<\/p>\n\n\n\n<h3>5. <strong>Lymphop\u00e9nie avec pancytop\u00e9nie<\/strong><\/h3>\n\n\n\n<p>My\u00e9lodysplasie, Aplasie m\u00e9dullaire<\/p>\n\n\n\n<h3>6. <strong>Lymphop\u00e9nie des maladies de syst\u00e8me<\/strong><\/h3>\n\n\n\n<p>Lupus \u00e9ryth\u00e9mateux diss\u00e9min\u00e9, Sarco\u00efdose.<\/p>\n\n\n\n<h3>7. <strong>Lymphop\u00e9nie\u00a0 ad\u00e9nopathique<\/strong><\/h3>\n\n\n\n<p>Maladie de hodgkin: ++++, Tuberculose ganglionnaire : rare<\/p>\n\n\n\n<h3>8. <strong>Lymphop\u00e9nie hormonale<\/strong><\/h3>\n\n\n\n<p>Corticoth\u00e9rapie, Hypercorticisme de cushing.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION Une lymphop\u00e9nie est d\u00e9finit par un taux de lymphocytes total &lt;&nbsp;1 500\/ mm3 chez l&rsquo;adulte&nbsp; ou&nbsp; &lt;3000\/ mm3 chez&nbsp;&hellip;<\/p>\n","protected":false},"author":1,"featured_media":693,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0},"categories":[2],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/688"}],"collection":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=688"}],"version-history":[{"count":3,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/688\/revisions"}],"predecessor-version":[{"id":698,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/688\/revisions\/698"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/media\/693"}],"wp:attachment":[{"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}