WBC Benign Disorders PDF

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

WBC & BENIGN DISORDERS DR IZATUS SHIMA TAIB Learning guideline: Leucogenesis Phagocytes - Granulocytes and monocytes Leucocytosis & monocytosis Neutropenia Histiocytic Disorders Immunocytes – lymphocytes Lymphocytosis – Infectious mononucleosis Lymphopenia Lymphadenopathy  A LEUCOGENESIS S granulocytes I Histiocytes  Leucocytes Functions Phagocytes Immunocytes · engulf Cells Granulocytes Monocyte Lymphocyte https://quizlet.com/202619660/leucogenesis-flash-cards/ Phagocytes 126 hypersegmented) 33-5 loyes) still see - bigger -can nucleus the granules -> basophil · redder in conc Granulocytes - against the parasite Monocytes 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 · rare be to found, short time in Good in tissue (form,deerI Granulopoiesis * due to diff. Stimulating factor, cells the can diff, diff. into cells Phagocytosis and bacterial destruction  optwho cannot synthesize glow win 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 - - pr M Neutrophil Leukaemoids Eosinophil leucocytosis - reactions leucocytosis -- R Basophil Monocytosis leucocytosis - - Neutrophil leucocytosis Increase in circulating neutrophils (> 7.5 X 109/l) Most frequent observed blood count changes Accompanied by fever (release of leucocyte pyrogens) Reactive neutrophilia: -> form more lobe is reactive neutrophil 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 Leukemia 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 leucocytosis -> fight parasite 3 immune Increase in blood basophil (> 0.1 X 109/ l) 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 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 ~growth factor 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 lymphohistiocytosis (haemophagocytic syndrome) Malignancies AML Immunocytes  The immunologically competent cells Assist the phagocytes in Lymphocytes the defence of the body Formation of lymphocyte – primary (BM and thymus), secondary (lymphoid organs – lymph nodes, spleen and lymphoid tissues of the alimentary and respiratory tracts.  sometimes confused monocytes with (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) 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 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 https://youtu.be/kKPkG1gflfo?si=Z_mSJhjWtG1H9Yzr  Lymphopenia ↓ lymphocyte in Good Occur in severe BM failure with corticosteroid and other immunosuppressive therapy Hodgkin’s disease Widespread irradiation Occur the most in AIDS ⑦>  Lymphadenopathy -Leukemia pt. node - lymph swollen atcertain are a O 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 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