In a patient with hypercortisolism, which finding would contribute to the potential for infection?

In a patient with hypercortisolism, which finding would contribute to the potential for infection?

• A. Decreased lymphocyte count
• B. Increased lymphocyte count
• C. Elevated neutrophils
• D. High platelet count

Answer: (A)

Excess cortisol suppresses the immune system, especially the adaptive branch driven by lymphocytes. Glucocorticoids reduce lymphocyte production and promote lymphocyte apoptosis, and they impair T-cell function and cytokine signaling needed for a targeted immune response. This lymphopenia weakens the body’s ability to fight infections, making infection more likely in hypercortisolism. Among the options, a decreased lymphocyte count directly reflects the cortisol-driven suppression of adaptive immunity and best explains the increased infection risk. While neutrophil changes can occur with stress or steroids, they do not account for the reduced ability to mount a specific immune response as clearly as lymphopenia, and a high platelet count isn’t a primary driver of infection susceptibility in this context.

Excess cortisol suppresses the immune system, especially the adaptive branch driven by lymphocytes. Glucocorticoids reduce lymphocyte production and promote lymphocyte apoptosis, and they impair T-cell function and cytokine signaling needed for a targeted immune response. This lymphopenia weakens the body’s ability to fight infections, making infection more likely in hypercortisolism. Among the options, a decreased lymphocyte count directly reflects the cortisol-driven suppression of adaptive immunity and best explains the increased infection risk. While neutrophil changes can occur with stress or steroids, they do not account for the reduced ability to mount a specific immune response as clearly as lymphopenia, and a high platelet count isn’t a primary driver of infection susceptibility in this context.