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
Oxygen radicals are
activity of the cells
increase with infections
phosphatase score is
useful to confirm
leukaemoid reaction from
Infections is the
Neutrophilia Left Shift:When increase
numbers of band forms of
granulocytes in circulation
When we see blast cells as
Haemorhage, HL, steroid
therapy can cause
NAPScore is useful to
reaction from leukaemia
Normal count is 0.04-
Eosinophilia 0.4x109 /l.
When it exeeds 0.4x109 /l it
is called eosinophilia
When the count is
Monocytosis more than 0.8x109 /l .
Seen commonly with
chronic infections like
When absolute count is
over 4x109 /l
Commonly seen in certain
Counts less than 2 x109 /l.
Associated with high risk of infections.
Causes include aplastic anaemia, marrow
infiltration, typhoid, hypersplenism, SLE
1.granulocyte infusions (buffy coats)
2. Treatment for the underlying disorder
Seen in young adults
Present with LN
throat, fever and
Rarely patients present
splenic rupture and
Differential diagnosis include acute
lymphoblastic leukaemia and lymphoma .
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
Self limiting infection