10 - Benign Leukocyte Disorders Flashcards
eosinophil protein that gives it eosinophilia
major basic protein
normal differential of WBCs
neutrophil - 55% lymphs - 35% monos - 6% eos - 3% basos - 1%
leukemoid reaction
reactive inc in WBC count, usually refers to granulocytes
immature forms may appear in peripheral blood
causes of neutrophilia
reactive:
infections (bacterial)
inflammation/necrosis
drugs, hormones, toxins (steroids, Cushings)
strong physical/emotional stimuli / trauma
neoplastic: myeloproliferative neoplasms
causes of eosinophilia
reactive: infxn (parasite, fungal) allergy drugs collagen vascular dz addison's dz
neoplastic:
myeloproliferative neoplasms
some T cell lymphomas/leukemias
causes of basophilia
rare - usually myeloproliferative neoplasm like CML
causes of monocytosis
reactive - neutropenia collagen vascular dz immune disorders infxns (viral, tb, syph, bact endocarditis
neoplastic -
myeloproliferative neoplasms and leukemias
causes of lymphocytosis
reactive: infxns (viral, pertussis, TB, rickettsia) infectious mononucleosis autoimmune drugs
neoplastic - lymphomas/leukemias
when does the absolute neutrophil count become alarmingly low
<500 is REALLY bad
consequences of neutropenia
inc risk of bacterial/fungal infection (more of a problem with acute drops than chronic process)
ulcerations of oral cavity, skin, GI, GU
sx related to infxn - fever, chills, malaise
causes of neutropenia
inherited - congenital, cyclic reactive- nutritional deficiencies drugs severe infxn autoimmune
neoplastic: acute leukemia MDS large granular lymphocyte leukemia tumor in bone marrow
Kostmann syndrome
rare AR disorder
causes agranulocytosis due to mutation in elastase
causes of monocytopenia
aplastic anemia
hairy cell leukemia
causes of lymphopenia
HIV immune deficiency infxns drugs (immunosuppressants) autoimmune dz malnutrition
dohle bodies - what are they
round/oval/rod pale gray/blue inclusions in neutrophil
stacks of RER or denatured aggregates of free ribosomes
when do you see dohle bodies?
normal pregnancy infxn various neoplasms severe burns trauma G-CSF therapy kwashiorkor
toxic granulation - what is it
fine coarse reddish granules in neutrophil
result from altered maturation of granules
when do you see toxic granulation
severe infxn other inflammatory states pregnancy trauma burns G-CSF therapy
when do you see vacuoles in cytoplasm of neutrophils?
septicemia acute alcohol poisoning carnitine deficiency kwashiorkor *may be artifact of sample hanging out in EDTA too long
Pelger Huet anomaly
AD inheritance
hyposegmentation of neutrophil
function is normal usually
when do you see hyposegmentation of neutrophils?
inherited - Pelger Huet anomaly acquired - myelodysplasia and AML drugs infxn (mycoplasma, HIV) rarely in bone marrow transplant pts
when do you see hypersegmentation of neutrophils?
most common - megaloblastic myelopoiesis
B12 or folate deficiency
alcoholism
drugs
chronic granulomatous disease
rare X linked disorder
defective oxidative burst - cant make H2O2, so catalase pos organisms cant be killed > make granulomas > recurrent abscesses, infections
May Hegglin anomaly
AD inheritance
intracytoplasmic inclusions in granulocytes and monocytes (looks like a basophilic shadow)
giant platelets
Chediak Higashi Syndrome
AR inheritance
reduced and abnormally large granules - look very unique
partial oculocutaneous albinism
recurrent infections
Alder Reilly anomaly
AR inheritance
seen in mucopolysaccharidoses
abnormally coarse azurophilic granules in neutrophils and sometimes lymphs and monos
