Abnormal white cell count Flashcards
Recall 5 causes of a high WBC count
Infection Inflammation Leukaemia Myeloproliferative disorder Apoptotic gene mutation
Recall 5 causes of a low WBC count
Aplastic anaemia Haematological cancer Metastatic cancer B12/ folate deficiency Immune breakdown
What is a common initial presentation of AML?
Sore throat
What would be seen in a blood film that was positive for leukaemia and not infection?
Immature WBCs
Recall the laboratory markers that are indicative of acute leukaemia, that distinguishes it from infection
Immature cells
Elevated wbc count
Low Hb
Low platelets
What is a normal value for white cell count?
4-11x10^9/ L
What is a normal value for neutrophil count?
2.5-7.5x10^9/L
Recall a possible cause for a neutrophilia that develops in a matter of minutes, hours and days
Minutes: demargination
Hours: early release from bone marrow
Days: infection
How do neutrophils appear in the blood in the presence of infection?
Toxic granulation vacuoles present
How do neutrophils appear in the blood in leukaemia?
High number of precursors
Recall infection examples that will not produce a neutrophilia
Brucella
Typhoid
Recall 4 common causes of a neutrophilia
Acute infection
Tissue inflammation
Underlying neoplasia
Malignancy
Recall 6 reactive causes of eosinophilia
Drugs Infection Parasitic infection Neoplasia Hypereosinophilic syndrome Allergy
How is eosinophilia stimulated by hodgkin’s lymphoma?
Lymphoma secretes the cytokine IL-5 which stimulates a reactive eosinophilia
What is the most important thing to look for when trying to establish the cause of a lymphocytosis and why?
Maturity of cells:
Mature cells indicate a reaction to infection, whereas immature cells are indicative of a leukaemia/ lymphoma
Recall 3 possible causes of lymphocytosis when the WBCs on the blood film are mature
CLL
AI
Inflammation
Recall a possible cause of lymphocytosis when the WBCs on the blood film are immature
ALL
Describe the differences in cell expansion between primary and secondary causes of lymphocytosis
Primary = monoclonal
Secondary (reactive) = polyclonal
Recall a cause of monoclonal lymphoid proliferation
CLL
Recall 4 causes of reactive lymphocytosis
Infection
AI
Neoplasia
Sarcoidosis
What is mononucleuosis syndrome also known as?
Glandular fever
Describe a blood film that is positive for mononucleosis syndrome
Immature lymphocytes that are ROUND and clumped together
What is glandular fever an infection of?
EBV infection of B cells via the CD21 receptor
What is the most common cause of lymphocytosis in the elderly?
CLL
Recall the 3 things to assess in order to distinguish a reactive polyclonal response from a lymphoproliferative disorder
Morphology
Immunophenotype
Gene rearrangement
How can immunophenotype be used to distinguish reactive polyclonal response from a lymphoproliferative disorder
Polyclonal expansion (infection)= 50:50 kappa:lambda light chains Monoclonal (lymphoproliferative) = kappa/ lambda restricted
How can gene rearrangement be used to distinguish a reactive polyclonal response from a lymphoproliferative disorder
In monoclonal response the Ig and TCR genes will have an identical configuration and not be rearranged
