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White Blood Cells

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					White Blood Cells
       Physiology of white cells




   Granulocytes and monocyte production is restricted to
    bone marrow after birth.
   The majority of lymphocytes are produced outside the b.m.
    in lymph nodes
   50 % of neutrophils in the vascular compartment are
    associated closely with blood vessel walls.
   Normally WBC 4-11x10 9/l DC is different in children and
    in adults
    Microbicidal
      activity
   Oxygen radicals are
    important.
   Alkaline phosphatase
    activity of the cells
    increase with infections
   Neutrophil alkaline
    phosphatase score is
    useful to confirm
    leukaemoid reaction from
    leukaemia
                  Infections is the
                   commonest cause.
Neutrophilia      Left Shift:When increase
                   numbers of band forms of
                   granulocytes in circulation
                  Leukaemoid reaction:
                   When we see blast cells as
                   well
                   Haemorhage, HL, steroid
                   therapy can cause
                   neutophilia
                  NAPScore is useful to
                   confirm leukaemoid
                   reaction from leukaemia
                Normal count is 0.04-
Eosinophilia     0.4x109 /l.
                When it exeeds 0.4x109 /l it
                 is called eosinophilia
                Causes:
                 allergy
                 parasites
                 Neoplasia: HL
                 polyarteritis nodosa
                 Loeffler’s syndrome
                 When the count is
Monocytosis       more than 0.8x109 /l .
                 Seen commonly with
                  chronic infections like
                 SABE, malaria,
                  Rickettsia.
                 Vasculitis, collagen
                  disorders
                 Selective neutrophil
                  production depression
                  disorders
Lymphocytosis

        When absolute count is
         over 4x109 /l
        Commonly seen in certain
         infections
        Viral infections,
         Infectious mononucleosis,
         brucellosis, tuberculosis
        CLL, NHL
              Neutropenia
 Counts less than 2 x109 /l.
 Associated with high risk of infections.
 Causes include aplastic anaemia, marrow
  infiltration, typhoid, hypersplenism, SLE
  etc.
 Treated with
1.granulocyte infusions (buffy coats)
2. Treatment for the underlying disorder
Infectious mononucleosis
             Seen in young adults
             Present with LN
              enlargement, sore
              throat, fever and
              splenomegaly
             Rarely patients present
              with
              thrombocytopenia,
              splenic rupture and
              rash
 Differential diagnosis include acute
  lymphoblastic leukaemia and lymphoma .
 Lab diagnosis
  WBC/DC, Blood picture , serological tests to
  detect heterophil antibodies (monospot test,
  Paul Bunnel test –during 2nd to 3rd week.)
 Do not do lymph node biopsy. Histological
  appearances are very similar to large cell
  lymphoma.
 Self limiting infection

				
DOCUMENT INFO
Description: Common haematological conditions