6.1 Leukopenia+Leukocytosis Flashcards
Monocytosis
-causes include (3)
- infection (inflammation)
- autoimmune (inflammation)
- malignancy
Neutropenia:
-what drugs can you use to tx?
- GM-CSF and G-CSF
- granulocyte/monocyte colony stimulating factor, to boost granulocyte production
Lymphopenia
-causes include? (4)
- Immunodeficiency (eg DiGeorge, HIV)
- High cortisol state (eg Cushing’s)
- Autoimmune (eg SLE)
- whole-body radiation
Infectious mononucleosis:
-the CD8 T cell response causes what things? (3)
- Lymphadenopathy (T cell hyperplasia in lymph node paracortex)
- Splenomegaly (T cell hyperplasia of PALS-periarterial lymphatic sheath)
- Atypical CD8 lymphocytes (look like monocytes)
How does DiGeorge syndrome affect blood cell count?
Causes lymphopenia.
-no development of 3rd/4th pharyngeal pouches means thymic aplasia, so no T cells can mature. Loss of T cell lymphocytes.
Infectious mononucleosis:
-EBV usually infects what in the body? (3 things)
- pharyngitis
- Liver–hepatitis, hepatomegaly
- B cells
How does pertussis infection affect lymphocytes, and how?
- increases lymphocytes in the blood (lymphocytic leukocytosis)
- bacteria produces lympocytosis-promoting factor, which blocks lymphocytes from leaving the blood to enter lymph nodes
Where does T cell hyperplasia occur:
- in lymph node?
- in spleen?
- lymph node–occurs in paracortex. (B cells are in cortex)
- spleen–occurs in PALS (periarterial lymphatic sheath), inside central white pulp
Infectious mononucleosis
-causes (2)
- EBV
- CMV (less common)
basophilia
-classic cause
-CML–chronic myeloid leukemia
SLE:
how can this affect blood cell count?
- can cause leukopenia, anemia
- SLE can create Ab to WBCs, RBCs, platelets
Infectious mononucleosis:
-complications (3)
- Splenic rupture (no contact sports for at least 1 month)
- Rash if exposed to penicillin
- EBV dormancy in B cells leads to complications: increased risk for 1) mono recurrence, 2) B cell lymphoma
eosinophilia
-causes include (3)
- allegic reactions
- parasitic infections
- Hodgkin lymphoma (from increased IL5 production)
Neutropenia:
-causes include? (2)
- Drug toxicity (chemotherapy)
- eg akylating agents damage stem cells - Severe infection (eg sepsis)
- increased movement of neutrophils out of blood and into tissues
Neutrophilic leukocytosis
-causes (3)
- Bacterial infection
- Tissue necrosis
- releases marginal pool and stimulate bone marrow to make immature neutrophils (decreased CD16) - high steroid use
- impairs leukocyte adhesion, so releases marginal pool
How does Hodgkin lymphoma affect eosinophils, and how?
- increases eosinophils
- through production of IL-5
Tests for EBV mononucleosis, and their mechs:
- screening test
- confirmation test
- monospot test–tests for IgM Ab against horse/sheep RBCs (heterophile Ab), takes 1 week
- Serologic testing for EBV viral capsid antigen
You see patient with infectious mononucleosis, but no sign of EBV. Suspect what?
-suspect CMV
lymphocytic leukocytosis
-causes include: (2)
- Viral infections–increase CD8 T cell count
- Pertussis infection (produces lymphocytosis-promoting factor, which blocks lymphocytes from leaving the blood to enter lymph nodes)
What happens to WBC count immediately after steroids are given?
-WBC count increases b/c steroids inhibit neutrophil adhesion to vessel walls. (release them from marginal pool)
Normal WBC count
5-10 K/microliter
what characterizes immature neutrophils, and when are they made?
- decreased CD16 (Fc receptor for binding to Ab for phagocytosis)
- you see these in the blood when neutrophil release is stimulated (by bacterial infection and tissue necrosis)
Leukopenia
- what WBC count defines this
- what are 2 categories?
1.
- Neutropenia, Lymphopenia
How is CML unique in affecting WBC levels?
-it is the classic cause for basophilia
