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clinical pathology > 14 - interpretation of leukograms > Flashcards

14 - interpretation of leukograms Flashcards

1
Q

what is the importance of absolute leukocyte counts

A
  • percentage leukocyte counts can be misleading
  • each leukocyte count has its own kinetics
  • each leukocyte count has its own functions
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2
Q

T/F only absolute cell counts are used when evaluating CBC data

A

true - percentages can be misleading

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3
Q

what are the species difference for carnivores on leukograms

A

neutrophils predominate in blood carnivores

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4
Q

what are the species difference for ruminants and rodents on leukograms

A

lymphocytes predominate in blood of ruminants and rodents

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5
Q

what is a breed difference that can show up in leukograms

A

lower neutrophil counts in greyhound and belgian tervuren dogs

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6
Q

how can age affect leukograms

A

Neonates - blood lymphocytes increase after birth

geriatric dogs - lower blood lymphocytes

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7
Q

explain bone marrow cell mitosis to maturation and storage

A

mitosis: myeloblast - promyelocyte - myelocyte
– to –
maturation: metamyelocyte - band - neutrophil (segmented)

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8
Q

what does a left shift mean in a leukogram

A

Increased immature neutrophils

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9
Q

what can cause a left shift on a leukogram

A
  • inflammation
    - infectious
    - non infectious
  • neoplasia (CML, AML)
  • hereditary (pelger huet, IMHA)
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10
Q

what makes a left shift regenerative

A

Regenerative left shift
- neutrophilia with left shift
- mature neutrophils predominate

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11
Q

what makes a left shift degenerative

A
  • normal neutrophil count or neutropenia
  • immature neutrophils predominate
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12
Q

what is the most common causes of toxic left shifts

A

strong inflammatory conditions, with severe bacterial infections

  • toxicity generally less prominent with immune- mediated, neoplastic, or hereditary disorders
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13
Q

list some causes of neutrophilia

A
  • epinephrine
  • glucocorticoids (endogenous or exogenous)
  • inflammation ( infectious or noninfectious)
  • chemical and drug poisoning
  • hemorrhage and hemolysis
  • malignancy including leukemia
  • hereditary neutrophil defects, especially adhesion molecule deficiencies
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14
Q
A
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15
Q

what happens during epinephrine-induced neutrophilia

A
  • no neutrophil toxicity or left shift
  • short duration (about 30 mins)
  • also lymphocytosis in young animals (especially cats)
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16
Q

what happens during a glucocorticoid- induced neutrophilia

A
  • neutrophilia without left shift
  • lymphopenia
  • eosinopenia
  • monocytosis (dogs)

There is a peak response the occurs in 4-8 hours. Neutrophil count may return to normal after several weeks of increased blood glucocorticoid concentration, but lymphopenia and eosinopenia remain

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17
Q

why does lymphopenia happen with glucocorticoids

A

glucocorticoid result in sequestration of lymphocytes in lymphoid organs
- long term glucocorticoid administration results in lysis of certain lymphocyte type or stages

18
Q

why does eosinopenia happen with glucocorticoids

A

glucocorticoids inhibit release of eosinophils from bone marrow

19
Q

what happens during “leukemoid” neutrophilia

A
  • total neutrophil count above 50,000/uL
  • marked left shift to include myelocytes
20
Q

what are some causes of “leukemoid” neutrophilia

A
  • infectious processes such as pyothorax, pyelonephritis, septic peritonitis, pyometra, abscess and pneumonia
  • immune-mediated disorders such as immune-mediated hemolytic anemia, glomerulonephritis, polyarthritis, and vasculitis

** differentiate from chronic myelogenous leukemia (CML)

21
Q

inflammation in cattle, sheep, manatees on a leukogram

A
  • sometimes minimal leukogram changes

increased acute phase proteins including SAA, fibrinogen and haptoglobin

22
Q

what is leukocyte adhesion deficiency I (LAD I)

A

a defect in CD18 (beta subunit of B2-integrin adhesion molecule) in irish setter dogs and holstein cattle

** marked neutrophilia

23
Q

what is leukocyte adhesion deficiency III (LAD III)

A
  • kindlin-3 protein deficiency in German shepherds
  • lack of activation of leukocyte and platelet integrins (B2-intergrin activation is critical)
    —– marked neutrophilia, platelet function defect also
24
Q

How does neutropenia happen in the body (pathophys)

A

decreased marrow production (decreased marrow progenitor cells)
- decreased precursor cells
- myelophthisis with decreased presursors
- dysgranulopoiesis

increased exit from the blood
- migration into tissue
- destroyed within blood

shift from circulating to marginal pool
(healthy belgian tervuren dogs)

25
Q

neutropenia is due to a decrease in what

A

marrow progenitor cells

26
Q

what are some causes of neutropenia

A
  • idiosyncratic drug reactions (phenylbutazone, trimethoprim/sulfadiazine, griseofulvin, and cephalosporins)
  • estrogen toxicity in dogs and ferrets (extrinsic or intrinsic)
  • cytotoxic chemotherapy drugs, colchicine toxicity
  • parvovirus infections
  • severe chronic Ehrlichia canis infection in dogs
  • cyclic hematopoiesis in grey collie dogs
27
Q

list some causes of myelophthisis

A
  • lymphoid leukemia (primarily ALL)
  • multiple myeloma
  • myelofibrosis (often only anemia)
  • osteosclerosis
  • metastasis of lymphomas, carcinomas, and mast cell tumors
28
Q

list some causes of neutropenia dysgranulopoiesis

A
  • myelodysplastic syndrome (MDS)
  • acute myelogenous leukemia (AML)
  • inherited cobalamin deficiency
29
Q

what are some causes of neutropenia because of increased utilization of destruction

A
  • acute infection before granulocytic hyperplasia has has time to occur
  • overwhelming sepsis or endotoxemia
  • immune-mediated destruction
30
Q

what are 2 types of inherited neutropenia

A

cyclic hematopoiesis in gray collies
- cyclic neutropenia
- neutropenia last 2-4 day

“trapped neutrophil syndrome” in border collies
- persistent neutropenia
-granulocytic hyperplasia in bone marrow
- mutation of the VPS13B gene

31
Q

what are some factors that play into purulent (neutrophilic) inflammation numbers on a blood neutrophil count

A
  • rate of margination
  • rate of migration into the tissue
  • rate of marrow disease
32
Q

when are neutrophil counts generally higher

A

neutrophil counts are generally higher with localized infections than with generalized infections of septicemias

33
Q

what are some causes of lymphocytosis (increase in lymphocytes)

A
  • epinephrine effect (especially young cats and horses)
  • antigenic stimulation (uncommon)
  • persistent lymphocytosis in bovine leukemia virus (BLV) infected cattle (common)
  • lymphocytic leukemias
  • lymphomas with leukemic blood expression
34
Q

what are some causes of lymphopenia

A
  • corticosteroid induced
  • acute systemic infections
  • experimental injection of IL-1 and TNF
  • interferons induce lymphopenia and lymphadenopathy (decreased egress from lymphoid tissues)
  • immunosuppressive drugs and radiation
  • loss of lymphocyte-rich lymph
  • disruption of lymph node architecture
  • hereditary T lymphocyte deficiency
35
Q

when does monocytosis occur

A
  • often occurs in association with neutrophilia
  • acute and chronic inflammation
  • glucocorticoids in dogs
  • acute myeloid leukemia (M4 and M5)
36
Q

T/F monocytopenia is not clinically sig as a single abnormality. monocytes may not be seen during manual differential counts

A

true

37
Q

what can cause eosinophilia

A
  • parasitic dz (especially nematodes and flukes)
  • allergic hypersensitivities
  • eosinophilic granulomas
  • occasionally mast cell tumors and other solid tumors
  • hyper eosinophilic syndrome/eosinophilic leukemia
  • chronic myelogenous leukemia
38
Q

what are some reasons for basophilia

A
  • IgE- mediated disorders
  • usually accompanies eosinophilia
  • may be associated with mast cell neoplasia (especially noncutaneous type mastocytosis)
  • basophilic leukemia (rare)
39
Q

T/F - basopenia is not clinically sig as a single leukocyte measurement abnormality. Basophils generally not seen during manual differential counts in normal dogs and cats.

A

true

40
Q

what can cause a mastocytemia

A

mast cell neoplasia

Dogs: inflammatory diseases, regenerative anemia, tissue injury, neoplasia other than mast cell tumors, and necrosis

cats: especially with splenic mast cell tumors

clinical pathology (18 decks)

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