11. Leukocyte Responses in Disease Flashcards
What is leukemia?
neoplastic cells in the blood and/or bone marrow
What is leukemoid response or reaction
can easily be mistaken for leukemia
Characterised by marked leukocytosis (>50.0x10^9WBC/L)
usually due to an inflam response
What is pancytopenia
refers to a dec in the number of all blood cell types
What is a left shift?
inc numbers of immature neutrophils in the blood
What is a degenerative left shift?
normal to dec #’s of mature neutrophils w/ equal or higher #’s of immature neutrophils BAD
What is leukopenia?
a dec in white blood cell numbers
leukopenia may be balanced with a dec in the # of all cellular elements, or it may be confined to one
nursing care and great nutrition are important to prevent 2nd infections & bone marrow function
What are common causes of leukopenia?
- viral infections
- Overwhelming bacterial infections
- anaphylactic shock and endotoxin shock
- Certain antibiotics
- Chemotherapeutic drugs
- Some analgesics
- Lead, mercury, antihistamines, & cortisone products
- A cachetic state (usually bc anorexia)
What is leukocytosis?
an inc in white blood cells
usually due to a rise in the number of circulating neutrophils
commonly occurs due to a physiological cause (As opposed to a pathological one)
What are some physiological cause of leukocytosis?
Exercise (more common in cats/eq)
Stress (common in dogs)
trauma, steroid therapy
chronic illness
DUe to an in in other cell types
What might happen to WBC’s with a stress response?
WBC changes that occur in response to stress, chronic illness, exercise or steroid supplementation
Absense of stress response in an animal that is sick is significant
What WBC stress response will you see in cats and dogs?
you’ll see a mature neutrophilia, monocytosis, lymphopenia, and possible eosinopenia**
What WBC stress response will you see in cattle?
reversal of neutrophil to lymphocyte ratio even if both are still within reference limits**
What WBC stress response will you see in horses
mature neutrophilia and lymphopenia**
What are the pathological causes of leukocytosis?
- systemic or localized infections - can cause marked neutrophilia (in dogs also monocytosis) with a possible left shift (Mastitis, peritonitis, metritis)
- Inflam, 3. acute hemorrhage (especially if its into body cavity*)
- Sudden lyses of erythrocytes*
- Some toxins,* 6. neoplasia
- Leukemia - may prod an inc in bizarre, atypical cell types and a severe left shift
*these cases usually = in neutrophilia with NO left shift, may be followed by monocytosis
What is leukocytosis?
the total leuckocyte response in an individual is directly related to the patient’s susceptibility to an infection, it’s immune status, and it’s general health
debilitated animals may fail to show the expected response - bone marrow may be affected by underlying condition
What is a left shift? WHat might you see?
refers to an increased conc of immature neutrophils in the peripheral blood
Band neutrophils are the first immature cells to appear
Metamyelocytes or earlier immature forms may also be seen
Which one indicates a more severe condition, neutrophilia or neutropenia?
Neutropenia
Orderly classification - there should be fewer immature cells than mature neutrophils
How are left shifts described?
Described to the degree of the shift
Termed slight or mild if shifted to the band neutrophil stage
Moderate if shifted to metamyelocyte stage
marked or severe if shifted to myelocyte or promyelocyte stage
What are regenerative left shift?
a leukocytosis due to a neutrophilia and appearance of immature neutrophils DO NOT out-number the mature neutrophils > bone marrow is responding to inflam stimulus
EX: seg N. - 45
Band - 15
Metamyelocyte - 6
myelocyte - 1
A marked regenerative left shift
Describe this left shift
Seg. N - 48, band N. - 11, metamyelocyte - 3
Moderate regenerative left shift
What are degenerative left shifts and what is an example of them?
Total WBC count often normal, but it can be above/below normal range
The immature neutrophils out-number mature ones > bone marrow no longer keeping up to the demands of the body - indicates poor px
Ex. Seg N - 8, Band - 25, metamyelocytes - 20, myelocytes - 1
Can animals go from a regenerative to a degenerative left shift?
Yes, but it will take some time to go from a regenerative to a degenerative shift
At first the body will be able to maintain a leukocytosis
In time, total WBC count will fall & a leukopenia will develops
What is the bone marrows ability to respond measured by? How is the intensity of the response measured by?
Bone marrow’s ability to respond is measured by total leukocyte count
Intensity of response measured by extent of left shift
What is a leukemoid response/reaction?
Characterized by severe leukocytosis (more than 50-100 x10^9wbc/L), most are mature Neutro\s, marked left shift myelocytes and metamyelocytes
cells show toxic granulation, dohle bodies and increased vacuoles
