Mechanism of Neutrophilia

Question 1

Granulocyte Production in Healthy Tissue

Answer 1

Unidirectional. This is the baseline for all cases to follow

Question 2

Acute Inflammation within the tissues

Answer 2

• Cytokines are released from the cells at the inflammatory site
• Those cytokines are going to increase release of the storage pool of neutrophils into the peripheral blood, and into the inflammed tissues

Question 3

Band Neutrophils in circulation

Answer 3

Storage pool as been used up, and we are now pulling from the maturation pool

Question 4

Acute Inflammatory Neutrophilia:

Expected

Answer 4

• Expected with significat inflammation of internal or subcutaneous tissue
  
  • Infection
  • Necrosis
  • Immune-mediated disease
  • Mediators easily access systemic blood

Question 5

Acute Inflammation Neutrophilia

NOT Expected

Answer 5

• NOT expected with lower urinary tract and superficial cutaneous lesions or oral cavity
  
  • mediators lost to urine, skin, or oral cavity

Question 6

Acute inflammation Neutrophilia

Brain and Spinal Cord

Answer 6

NOT seen with inflammation of the brain or spinal cord

Mediators do not leave the protected environment

Question 7

Chronic Inflammatory Neutrophilia

Answer 7

• Mediated by:
  
  • cytokines from inflammatory site ongoing for at least 1 week
• Granulocytic Hyperplasia
  
  • increased stimulation for proliferation
• Storage pool has been rebuilt and will be released into the tissue
  
  • mature neutrophilia
• Little or NO Left Shift
• Does not always follow an acute inflammatory response.

Question 8

Glucocorticoid-associated (Steroid aka Stress) Neutrophila

Answer 8

COMMON

• Mediated by:
  
  • cortisol
  • Prednisone
  • Prednisilone
• Shift from Marginating Pool to the Circulating pool
• Decreased migration to the tissue
• NO LEFT SHIFT
• Increased released from the storage pool.

Question 9

Segmented Neutrophil

Answer 9

Difinitive identation in nuclear outline

HEALTH

Question 10

Hypersegmented Neutrophil

Answer 10

5 or more definitive lobes

STEROIDS

Chronic inflammation probably due to stress

Question 11

Excitement / Physiologic Neutrophilia

Answer 11

Especially in Cats where Marginating pool is ~3X circulating pool

• Mediated by:
  
  • Catecholamines
    
    • epinephrine
    • norepinephrine
• Shift from marginating pool to circulating pool
• Fight or flight response
• No change in the bone marrow, or anything coming out of the bone marrow.
• TRANSIENT