Leukocytosis Flashcards
What is normal WBC count?
4000-11000 cells/uL
What is an enzyme found in WBCs that is typically not present in cancerous cells?
Leukocyte alkaline phosphatase (LAP)
If not elevated with high WBC count, suggestive of cancer
What is a leukemoid reaction?
(1) Non-cancerous elevation of WBCs as a result of (2) infection or (3) stress, often characterized by (4) presence of early precursors and (5) elevated LAP
What is the differential diagnosis of secondary neutrophilia?
(1) Infection
(2) Chronic inflammation
(3) Physiologic stress (burn, exercise, seizure)
(4) Marrow stimulation
(5) Splenectomy (major storage location for WBCs)
(6) Medications (glucocorticoids, lithium, beta agonists)
(7) Smoking
What can be observed in neutrophilia from infection?
(1) Left shift, increased bands
(2) Dohle bodies (blue-grey inclusions that are remnants of RER) and toxic granules
What are three causes of primary neutrophilia?
(1) Hereditary neutrophilia syndrome (splenomegaly, skull abnormalities, elevated LAP)
(2) Chronic idiopathic neutrophilia
(3) Down Syndrome
What is the cause of leukocyte adhesion deficiency?
Neutrophils are defective and lack CD18, preventing margination and leading to infection despite high circulating neutrophils
What are four primary immune disorders of leukocytosis?
(1) Hyper IgM
(2) Common variable immunodeficiency (CVID)
(3) X-linked agammaglobulinemia
(4) Cyclic neutropenia
What are five secondary causes of lymphocytosis?
Infection: (1) viral (EBV, HIV), (2) bacterial (Bartonella, Brucella, syphilis)
(3) Stress
(4) Splenectomy
(5) Hypersensitivity reactions
At what absolute eosinophil count can end stage organ damage occur?
AEC > 500 in blood
What parasitic infections cause eosinophilia?
(1) Strongyloides stercoralis
(2) Trichonella
(3) Toxocara
