Most Common Causes Low WBC can have a variety of causes.

Possible causes include viral infections, congenital disorders, autoimmune disorders and drugs such as prednisone, antibiotics and diuretics. Severe allergic reactions, parasitic diseases and vitamin deficiencies are other examples of causes of low WBC count. White blood cell counts can drop as the result of chemotherapy, radiation or certain types of cancer. Low WBC count can also indicate diseases of the liver or spleen or collagen-vascular diseases such as lupus erythematosus INTRODUCTIONUPPER GASTROINTESTINAL BLEEDING Originates in the GI tract from the mouth to the ligament of Treitz where the duodenum, thefirst part of the small intestine, ends. Bleeding from the esophagus may occur from esophagealvarices, dilation of the veins in the esophagus. One of the symptoms of upper GI bleeding isvomiting of blood (hematemesis).If the blood travelsthrough the GI tract, the stool may appear tarry and black (melena) because of digested blood,though the stool can still be stained with red blood (hematochezia). About 75% of patientspresenting to the emergency room with GI bleeding have an upper source. The diagnosis iseasier when the patient has hematemesis. In the absence of hematemesis, 40% to 50% of patients in the emergency room with GI bleeding have an upper source. Determining whether apatient truly has an upper GI bleed versuslower gastrointestinal bleedingis difficult. Mortalityis about 11% in patients admitted with an UGIB.2 It is as high as 33% in patients whodevelop bleeding whilst in hospital. A score of less than 3 using the Rockall system above isassociated with an excellent prognosis, whereas a score of 8 or above is associated with highmortality.3 Most deaths occur in elderly patients with co-morbidity. Mortality is reported to belower in specialist units possibly because of adherence to protocols rather than because of technical advances.2 The prognosis in liver disease relates significantly to the severity of theliver disease rather than to the magnitude of the haemorrhageUpper gastrointestinal bleeding is commonly caused by bleeding varices (varicose veins) in theesophagus, peptic ulcers or a Mallory- Weiss tear at the esophageal gastric junction fromsevere retching .Otherwise, bleeding over time results in anemia, characterized by lower thannormal blood hemoglobin and hematocrit with symptoms like weakness, fatigue, and fainting.The most important step to evaluate upper GI bleeding is upper endoscopy. During thisprocedure, performed by a gastroenterologist, a tube with a camera (endoscope) is passedinto the mouth and down the esophagus. The gastroenterologist can proceed to the stomachand duodenum and localize the source of the bleeding, if possible. Other examination todetermine UGIB areVital signs, in order to determine the severity of bleeding and the timing of intervention.Abdominalandrectalexamination, in order to determine possible causes of hemorrhage. Assessment forportal hypertensionandstigmata of chronic liver diseasein orderto determine if the bleeding is from a variceal source Causes of Low Levels Anemia arises as a direct result of a lack of red blood cells in the body, so any activity or function that causes RBC to shorten their life span, can be considered a cause of anemia. These red blood cells are created in the bone marrow, and their usual life span is about 120 days. There are two general categories into which the causes of anemia can be grouped, and they are as follows. When the production of the red blood cells in the body gets disrupted or stops completely. When there is an unpredicted amount of blood lost from the body, or destroyed. The means of discerning the hematocrit levels in the body are Mean Corpuscular Volume (MCV) and the Red Cell Distribution Width (RDW), and these help doctors determine if a person is suffering from low hemoglobin and hematocrit levels in the body. The MCV determines the actual size of the blood cells, and the RDW determines the differences in size between all the red blood cells. If a person suffering from these low levels also shows low MCV levels but high RDW levels, then the condition is being caused by a chronic iron deficiency. On the other hand, a normal RDW level accompanying a low MCV level signifies a different channel of blood loss, most notably through a hemorrhage in the body. Here are some types of people who are more prone to these conditions than others. Children who have an insufficient amount of iron in their diet. Children who have a sudden growth spurt, because of which the iron present in the body cannot keep up. Women who are pregnant for more than 4 months. Women who have recently given birth. People with chronic kidney disease Causes of Low RBC Count Anemia: In this condition the overall blood count has less than the normal number of RBCs or less than the normal quantity of hemoglobin in the blood, decreasing the oxygen carrying capacity of the blood. Anemia includes most forms; sickle cell anemia, aplastic anemia, poor nutrition, heavy menstrual bleeding, etc. Immune System Disorders: Most autoimmune diseases, cause the immune system to attack the body's own blood cells and tissues by mistake. Autoimmune diseases that affect blood and blood vessels include autoimmune hemolytic anemia, systemic lupus erythematosus, pernicious anemia, etc. Spleen Problems: The spleen is part of the lymphatic system. Its smooth functioning is required for fighting infection and keeping the body fluids in balance. The spleen's tissue, reticuloendothelial tissue, monitors red blood cells, eliminating abnormal, damaged and/or old ones that hamper functions. Any spleen disorder may hamper the work of this tissue leading to decreased RBCs in blood. Leukemia: Leukemia is a cancer of the blood cells, that affects the bone marrow. Bone marrow is the soft tissue present inside most bones, and a place where blood cells are made. It basically affects the white blood cells first, causing them to abnormally multiply, eventually crowding other blood cells including the RBCs.

Hodgkin's Disease: Hodgkin's disease is a cancer of the lymphatic system. It occurs in the lymph nodes, spleen, liver and bone marrow. As the lymph nodes, spleen and the bone marrow are essential to maintain a normal RBC count, any disorder in them can result in a low count. When one is having a low level of RBCs in blood, it is common to feel fatigued, weak, lightheaded, head aches, pale eyes and skin, shortness of breath, etc. Less RBCs mean a lower resistance to infection. A test to determine how low is the count and subsequently to determine its cause, is generally recommended by the physician. Causes of WBCcount There are several reasons why the level of leukocytes may lower. This drastic reduction can be a result of bacterial or viral infections, cancer, congenital disorders of the immune system and the bone marrow and also due to some therapies etc. Certain drugs like diuretics, immunosuppressants, clozapine and anti psychotics can also lead to a drop in the level of white blood cells in the body. Low white blood count causes in children can result in a number of serious ailments, which can be lifethreatening and also prove fatal in some cases. A deficit of lymphocytes can affect the body in a number of ways like a compromised immune system, delay in the healing of wounds etc. Mentioned below are some of the specific reasons for low white blood count: Autoimmune disorders that tend to destroy the bone marrow and hamper the production of white blood cells. Severe allergic reactions caused due to the presence of pathogens in the body. A condition known as hyperthyroidism, which is caused due to the overproduction of the thyroid hormone. Disorders in the liver or spleen. This condition can result in hypersplenism, where the blood cells are destroyed completely. Deficiency of vitamins and minerals. Congenital disorders, like Kostmann's syndrome, Myelokathexis, Myelofibrosis and Myelodysplastic syndromes etc., which can damage the function of the bone marrow. Inflammatory diseases like rheumatoid arthritis. HIV/AIDS can also be responsible for the dip in the number of leukocytes in the body. Other causative factors for reduced leukocytes in the body include leukemia, chemotherapy, radiation therapy, and systemic lupus erythematous which is results in damage of the tissues due to infection. Causes of Low Levels of Hemoglobin So if your hemoglobin level is lower than the lower limit for your group, that means you have low hemoglobin levels. Low hemoglobin levels are usually due to nutritional deficiency especially iron deficiency. If you are not consuming the required daily amount of iron, vitamin B12 and folate, you are going to have the problem. One of the reasons for perpetually low levels is a bone marrow problem. Among temporary reasons of low levels we have accidents or surgeries that led to severe loss of blood and medications that may affect hemoglobin levels. A rather serious cause is anemia, the cause of which can be low intake of vitamins or chronic diseases. Hemoglobin levels can be resurrected by following a balanced diet. A person with low hemoglobin levels needs to consume enough iron, vitamin B12 and folic acid. If that doesn't work, then one may have to resort to consuming the above nutrients externally in the form of supplements. hematocrit and Hemoglobin Levels A low hematocrit and low hemoglobin count could be pointers towards many conditions. One of the most severe of these conditions is hemorrhage. Hemorrhage occurs when there is bleeding, which may be internal or external. Hemorrhage leads to a significant amount of loss of whole blood, which could lead to excess loss of blood cells. In such cases, finding out the mean corpuscular volume and the red cell distribution width can be helpful in evaluating the results obtained. However, one of the most common inferences of low hematocrit and hemoglobin is anemia. Anemia is a serious condition where the hemoglobin drops to anywhere below 7 mg/dl. This condition is characterized by symptoms like shortness of breath, sleep apnea, constant fatigue and weakness, etc. There are many risk groups as far as anemia is concerned. In fact, a lowered hemoglobin and hematocrit during pregnancy is often an indicator of iron deficiency anemia. This was all about the normal hematocrit and hemoglobin values and what changes in these levels mean. There are many other uses of measuring the hematocrit as well. The hematocrit of professional athletes is measured as a part of tests for blood doping or erythropoietin use. The level of hematocrit in a blood sample is compared with the long term level for that athlete so that there is a small window for individual variations in hematocrit level and against an absolute permitted maximum. The maximum expected levels are those that are seen within the population including the hematocrit level which causes an increased risk of blood clots resulting in strokes heart attacks.