WBC & Benign Disorders PDF

WBC & BENIGN DISORDERS DR IZATUS SHIMA TAIB Learning guideline: Leucogenesis Engulf Phagocytes - Granulocytes and monocytes Leucocytosis & monocytosis Neutropenia Histiocytic Disorders Immunology reaction Immunocytes – lymphocytes Lymphocytosis – Infectious mononuc...

WBC & BENIGN DISORDERS DR IZATUS SHIMA TAIB Learning guideline: Leucogenesis Engulf Phagocytes - Granulocytes and monocytes Leucocytosis & monocytosis Neutropenia Histiocytic Disorders Immunology reaction Immunocytes – lymphocytes Lymphocytosis – Infectious mononucleosis Lymphopenia Lymphadenopathy  Leucocytes Erythrocytes LEUCOGENESIS -content granules inside organ - granulocytes chistiocytes  Leucocytes Functions Phagocytes Immunocytes Cells Granulocytes Monocyte Lymphocyte LBaso ↳ Eosino ↳ mentro https://quizlet.com/202619660/leucogenesis-flash-cards/ Phagocytes  color ↑ concentration gramue than Baso - higher concentration. -granules bigger - nucleus seen - Normal - 3 to 5 lobes Granulocytes Monocytes - - rare to find less time in Good Larger than other peripheral blood leucocyte Large central oval or indented nucleus with clumped chromatin Cytoplasm stains blue and contains many fine vacuoles, giving a ground- glass appearance Spend only short time in marrow (20 – 40 h) > tissue for maturation and carry their principal function pendroglic Granulopoiesis  no stimulating factor stimulating factor M chemokine ↳ to induce other reaction Ja Phagocytosis and bacterial destruction  Chemotaxis Phagocytosis Occur in rare congenital abnormalities & acquired Lack of opsonization due to abnormalities congenital/ acquired cause of hypogammaglobulinemia/ lack of complement Killing and Chemokines Rare X-linked or digestion autosomal recessive chronic granulomatous disease results from abnormal leucocyte oxidative metabolism Phagocytes Functions  Leucocytosis & Benign monocytosis disorders of Neutropenia Granulocytes & monocytes Histiocytic Disorders  1) Leucocytosis and Monocytosis Neutrophil Leukaemoids Eosinophil leucocytosis reactions leucocytosis increased Basophil Monocytosis leucocytosis Neutrophil leucocytosis ↳ accompanied in fever Increase in circulating neutrophils (> 7.5 X 109/l) Most frequent observed blood count changes Accompanied by fever (release of leucocyte pyrogens) Reactive neutrophilia: a) ↑ band forms, more primitive cells (metamyelocyte and myelocyte) b) Presence of cytoplasmic toxic granulation and Doehle bodies c) ↑ neutrophil alkaline phosphatase (NAP score) Causes of Neutrophil leucocytosis  Leukaemoids reactions = Leukemics patient Reactive and excessive leucocytosis Presence of immature cells (myeloblasts, promyelocytse and myelocytes) in peripheral blood Severe or chronic infections, severe hemolysis or metastatic cancer Marked in children Presence of toxic granulation, Doehle bodies and ↑ NAP score to differentiate with CML Eosinophil leucocytosis Increase in blood eosinophils (> 0.4 X 109/ l) More than 6 months (> 1.5 X 109/ l) and associated with tissue damage (hypereosinophilic syndrome) Basophil - parasite s allergic reaction leucocytosis Increase in blood basophil (> 0.1 X 109/ l) secondary to Cause by myeloproliferative disorder due to CML or polycythaemia vera Sometime seen in myxoedema, during smallpox or chickenpox infection and ulcerative collitis  Monocytosis Increase monocyte (> 0.8 X 109/ l)  2) Neutropenia ↓ normal neutrophil count Congenital Drug-induced Selective Cyclical neutropenia Autoimmune Idiopathic benign Causes Part of general BM failure pancytopenia Splenomegaly - first player for inflammation Neutropenia - Clinical features Infections of the mouth and throat Painful intractable ulceration (skin, anus) Commensals organisms – become pathogens Neutropenia - Diagnosis BM examination Neutropenia - Management Early recognition and vigorous treatment with antibiotics, antifungal or antiviral agents Hematopoietic GF (G-CSF) to stimulate neutrophil production Corticosteroid therapy or splenectomy – autoimmune neutropenia  Dendritic cells Langerhan’s cell histiocytosis 3) Histiocytic Macrophage-related Disorders Hameophagocytic crare) lymphohistiocytosis (haemophagocytic syndrome) Malignancies AML lAcute myloid lymphoma Immunocytes  The immunologically competent cells Assist the phagocytes in Lymphocytes the defence of the body ↳ immunology part Formation of lymphocyte – primary (BM and thymus), secondary (lymphoid organs – lymph nodes, spleen and lymphoid tissues of the alimentary and respiratory tracts. (a) small lymphocytes,(b) activated lymphocytes, (c) large granular lymphocytes, (d) plasma cell lymphocytes B and T cells, Natural killer cells B cells form in BM T cells form in BM thymus (maturation) every selective > Hard to activate reaction ( During maturation – delete the self-reactive T cells (-ve - selection) and remain the T-cells with some specificity for host human leucocyte antigen (HLA) Mature T cells express CD4 and cytotoxic cell express CD8 NK cells cytotoxic CD8+ cells (Lack of T-cell receptor)  Lymphocytosis Increase of Lymphocyte count Often occurs in infants and young children in response to infections The most common cause is EBV infection (Epstein-Barr Virus) – INFECTIOUS MONONUCLEOSIS  Infectious mononucleosis https://youtu.be/MYfiei0n4KY?si=6Sod3y0dXZHgZBaF Diagnosis of Infectious Mononucleosis ↑ lymphocyte 1) TWBC – lymphocytosis (pleomorphic atypical lymphocytosis) – 7th to 10th day of the illness. 2) Serological test – Paul-Bunnel test 3) EBV antibody – If viral diagnostic facilities are available  check for EBV capsid Ag 4) Hematological abnormalities – AIHA cold type, thrombocytopenia, autoimmune thrombocytopenia purpura (rare)  Paul-Bunnel test ↳Heterophile antibody (monospot ↳ infected Bell https://youtu.be/kKPkG1gflfo?si=Z_mSJhjWtG1H9Yzr & Anti-VCa antibody ↳ viral capsid antigen Anti-EBNA antibody D ↳ nuclear antigen  Lymphopenia Occur in severe BM failure with corticosteroid and other immunosuppressive therapy Hodgkin’s disease Widespread irradiation Occur the most in AIDS  Lymphadenopathy O - swollen symph -usually late stage Summary  Quantitative Change in number Terminology Cytosis/ philia Leucocytes ↑ in number Benign Cytopenia ↓ in number Disorders Qualitative Morphologic changes Functional changes  TWBC count Relative vs absolute Differential values count Absolute count Better Leucocytes Benign Disorders Differential gives the relative Quantitative percentage of each WBC changes Absolute value gives Calculation: the actual number absolute count = of each WBC/mm3 total WBC X percent of blood Thank you