Hematology II (LS-HEH II 201) Leucocytes Benign Disorders Lecture Notes PDF

Hematology I (LS-HEH I 201) Leucocytes benign disorders Asaad Mohammed Ahmed Associate Professor BSc, MSc, PhD، H (ASCPi)، SH (ASCPi)Hematology December 17, 2024 w...

Hematology I (LS-HEH I 201) Leucocytes benign disorders Asaad Mohammed Ahmed Associate Professor BSc, MSc, PhD، H (ASCPi)، SH (ASCPi)Hematology December 17, 2024 www.gmu.ac.ae College of Health Lecture Contents: The factors that determine leukocyte counts in the peripheral blood. The major causes of granulocytosis (neutrophilia) and other forms of leukocytosis. The causes and consequences of leukopenia. The mechanisms underlying qualitative disorders of neutrophil function. The causes and consequences of hemophagocytic lymphohistiocytosis (macrophage activation syndrome).  Nonmalignant leukocyte disorders - Disorders affecting leukocytes can be divided broadly into malignant disorders (tumour of leukocytes or their progenitors) and non-malignant (benign) disorders. -White blood cell disorders arise when there is an abnormal count of white blood cells, either too high or too low -White blood cell disorders fall into quantitative (Number) or qualitative (Shape &Function) disorders. Leucocytes benign disorders Quantitative Change in number Terminology Cytosis / philia Increase in number Cytopenia Decrease in number Qualitative Morphologic changes Functional changes  LEUCOCYTES BENIGN DISORDERS Quantitative changes Leukocytosis is a condition characterized by an elevated number of total white cells in the blood (TWBCs), which is usually due to:  Bacterial infection such as appendicitis, tonsillitis, ulcers and urinary tract infection  Leukemia.  Pregnancy.  Hemolytic disease of newborn.  Following exercise.  Granulocyte Functions & Quantitative changes Neutrophils (↑ in bacterial infections) Phagocytosis of bacteria Releases antimicrobial chemicals Eosinophils ↑ in parasitic infections or allergies Phagocytosis of antigen-antibody complexes, allergens & inflammatory chemicals Release enzymes destroy parasites such as worms Basophils (↑ in chicken pox, sinusitis, diabetes) Secrete histamine (vasodilator) Secrete heparin (anticoagulant)  Agranylocyte Functions & Quantitative changes Lymphocytes (↑ in diverse infections & immune responses) Destroy cancer & foreign cells & virally infected cells “Present” antigens to activate other immune cells Coordinate actions of other immune cells Secrete antibodies & provide immune memory Monocytes (↑ in viral infections & inflammation) Differentiate into macrophages Phagocytize pathogens and debris “Present” antigens to activate other immune cells (APC) Another name of Monocyte (Macrophages) Cell Name Anatomical Location Adipose tissue macrophages Adipose tissue Monocytes Bone marrow/blood Kupffer cells Liver Sinus histiocytes Lymph nodes Alveolar macrophages (dust cells) Pulmonary alveoli of lungs Tissue macrophages (histiocytes) leading to giant cells Connective tissue Langerhans cells Skin and mucosa Microglia Central nervous system Osteoclasts Bone Epithelioid cells Granulomas  Leukemoid reaction Definition: - Extremely high leukocyte counts seen in a non- leukemic state and may be lymphoid or granulocytic in nature - A leukemoid reaction is defined as a white blood cell count above 50,000 cells per microliter (µL) of blood. Causes:  Severe infections  Extensive burns  Malignancies with bone marrow infiltration  Severe hemorrhage  Lymphoid reactions seen usually in children in response to viral infections  drug side effects Leukemoid reaction  Leucocytes benign disorders Quantitative changes (LEUCOPENIA)  Leucopenia Definition TWBC lower than the reference range for the age is defined as leucopenia  Leucopenia may affect one or more lineages and it is possible to be severely neutropenic or lymphopenic without a reduction in total white cell count. LEUCOCYTES BENIGN DISORDERS Quantitative changes (NEUTROPENIA) contd. Causes of Neutropenia Racial Congenital Marrow aplasia Marrow infiltration Megaloblastic anemia Acute infections  Typhoid, TB, viral hepatitis Drugs Irradiation exposure Immune disorders  HIV  SLE(systemic lupus erythromatosus  Neonatal isoimmune and autoimmune neutropenia Hyperslplenism  Causes of Lymphocytopenia Infectious diseases, such as AIDS, viral hepatitis, tuberculosis, and typhoid fever. Autoimmune disorders, such as lupus.... Steroid therapy. Blood cancer and other blood diseases, such as Hodgkin's disease and aplastic anemia. Radiation and chemotherapy (treatments for cancer)  Qualitative changes (MORPHOLOGY) Leucocytes benign disorders Leucocytes benign disorders Qualitative changes (MORPHOLOGY) Congenital Pleger-Huet anomaly Neutrophil hyper-segmentation May-Hegglin anomaly Alder’s anomaly Chediak-Higashi syndrome  Leucocytes benign disorders Qualitative changes (MORPHOLOGY) contd. Acquired  Toxic granulation  Dohle bodies  Pelger cells  Hypersegmented neutrophils LEUCOCYTES BENIGN DISORDERS Qualitative changes (FUNCTIONAL) Leucocyte adhesion deficiency Chronic granulomatous disease Chediak-Higashi syndrome Primary immunodeficiency