Leukocytes in disease Flashcards
What do neutrophils do?
Search, ingest and destroy bacteria.
Rarely, we will see bacteria in the neutrophils seen in blood stream - e.g. diplococci in meningococcal sepsis
How do neutrophils move from the bloodstream into tissue?
rolling (selectin protein),
slow rolling (selectin + integrin), arrest, crawling, transmigration,
NB about 1/2 of our neutrophils are rolling along the endothelium, we call this margination
What are the two neutrophil destinies?
NETosis
Apoptosis
Netosis is literally forming a net of chromatin + proteases
Name some causes of increased neutrophils
Infection
Steroid (prednisone decreases margination)
Chronic mild: smoking, obesity
What is meant by left-shift in neutrophils?
Shift towards immature neutrophils - e.g. BANDED neutrophils
Signifies infection as more neutrophils produced
What might you see in neutrophils if there is a severe infection?
Left shift
Toxic granulation
Vacuolation
What causes neutropenia?
Bone marrow disease
Chemotherapy
Drug side effects
Viral infections (e.g. glandular fever)
Genetic neutropenia
Fulminant bacterial infections
Which conditions impair neutrophil function?
Diabetes, alcoholism and renal failure all reduce phagocytosis
Steroids reduce margination
What is a leukoerythroblastic blood film?
Immature WBCs and RBCs in the blood film
Severe bone marrow disease (e.g. laeukaemia, lymphoma)
What is the common cause(s) of lymphocytosis in the following age groups?
Children
Young adults
Adults
Elderly
Children: viral infections, pertussis, ALL
Young adults: EBV
Adults: CMV, toxoplasmosis, acute HIV
Elderly: CLL
What is the most common lymphocyte in the blood?
T cells make up 60-80%, then B cells 15% and NK 5%
What is acute myeloid leukaemia?
Myeloblasts in bone marrow - rapid growth, nasty will die in weeks if untreated
Myeloproliferative disorders - name them + prognosis
1) red cells
2) platelets
3) granulocytes
1) rbcs - polycythaemia vera (decades)
2) platelets - essential thrombocythaemia (decades)
3) granulocytes - chronic myeloid leukaemia (5 years untreated)
What is myelodysplastic syndrome?
Myeloid cells are defective in the marrow
What are the lymphoid cancers? Hint:4
ALL - rapid proliferation of large lymphoblasts
Lymphoma - mature cells, usually in the lymph node
CLL - slow proliferation of amture B cells in blood
Plasma cell myeloma: clonal proliferation of antibody-producing B-cells/plasma cells
