Non-malignant WBC Disorders Flashcards
Neutrophilia
Increased neutrophils >7.0 x 10^9/L
Not pathogenic (usually)
Exercise, anesthesia, newborn
Pseudoneutrophilia
No increase in bands
Redistribution of MGP and CGP
Acute Neutrophilia
Bacterial infection/toxin
Bone marrow response (shift left)
10-20 K
Chronic Neutrophilia
Continuous stimulation
Bone marrow storage depletion
Toxic granulation with Dohle bodies
Bacterial infection
Leukemoid Reaction
Extreme reaction to severe infection
Necrotic tissue
Usually >25k
Many immature cells
Leukemoid Reaction Lab Results
Normal RBC
Normal Platelet
Toxic granulation
Dohle Bodies
LAP increased
Neutrophilia Other Causes
Tissue necrosis
Burns
Rheumatoid arthritis
Tumors
Steroids
Pregnancy
Neutropenia
<2.0 x 10^9/L of 1.5 x 10^9/L
Decreased Bone Marrow production
Stem cell disorders
Neutropenia Causes
Radiation
Chemotherapy
Myleophthisic anemia
Megaloblastic anemia
Inherited disorders
Increased WBC loss
Severe infection
Immune loss
Hypersplenism
Hemodialysis
Viral infection
Pseudoneutropenia
Increase in MGP
Transient
Agranulocytosis
<0.5 x 10^9/L
Possibility of severe infection
Chronic Granulomatous Disease
Inherited
Abnormal Oxidative metabolism
Recurrent infections
Nitroblue tetrazolium test (NBT)
Chediak Higashi Anomaly
Inherited
Fusion of primary and secondary granules
Abnormal lysosomes
Hypopigmentation
Death in infancy
May-Hegglin Anomaly
Inherited
Large basophilic inclusions in cytoplasm
+/- Thrombocytopenia
+/- Bleeding
Pelger-Huet Anomaly
Benign, Inherited
Hyposegmentation (bi-lobed segs and inc bands)
Pince nez cells (old spectacle look)
Normal Cell function
Alder Reilly Anomaly
Inherited
Large, purple granules in WBC cytoplasm
Enzyme deficiency
Cells appear as clusters and may have vacuoles
Normal cell function
Myeloperoxidase Deficiency
Inherited
No increase in infection - alternative methods to kill bacteria
Causes technical error with instruments
Leukocyte Adhesion Deficiency
Inherited
Absence of WBC surface adhesion proteins (integrins)
Defects in adhesion, chemotaxis, phagocytosis, degranulation
Frequent infections
High mortality
Systemic Lupus Erythematosis (SLE)
Connective Tissue Disease
Anti DNA acts on WBC (LE factor)
Round, homogenous body ingested by neutrophil (LE cell)
Butterfly rash
ANA testing
Eosinophilia
> 450/cumm
Parasitic infection
Allergy
Asthma
Hypersensitive Skin Disease
Hematologic Malignancy
Tryptophan
Hypereosinophilia Syndrome
> 1500/cumm
Tissue infiltration and damage
Charcot Leyden crystals
Nasal and Paranasal sinus contents - allergic rhinitis
Eosinopenia
Hard to define
Cushing’s syndrome - bodies produce too much cholesterol
Basophilia
> 150/cumm
Immediate hypersensitivity reactions and MPD
Malignancy
Basopenia
Difficult to establish
Due to inflammation and immunologic reactions
Monocytosis
> 800/cumm
Inflammatory conditions and malignancies
Recovery stage of acute infection and agranulocytosis
Immune response to TB
Collagen vascular disorders
Fungal infections
Monocytopenia
<200/cumm
Hard to establish
Stem cell disorders
Lipid Storage Disorders
Deficiency in enzyme to phagocytose material
Gaucher’s Disease
Accumulation of lipid in macrophages
Deficiency in B-glucocerebrosidase
Pancytopenia
Splenomegaly, Bone pain
Increased serum phosphatase
Nieman-Pick Disease
Ashkenazie population
Deficiency of spingomyelinase
Poor physical development
Foamy macrophages
Often fatal by 3 yrs old
Tay-Sachs Disease
Ashkenazie population
Deficiency of B-hexoseamidase
Accumulation of glycolipids & mucopolysaccharides
Affects CNS
Often fatal by 4 yrs old
Sea Blue Histiocyte Syndrome
Inherited - Benign
Splenomegaly
Decreased platelets
Sea Blue staining macrophages in spleen and bone marrow
Lymphocytosis
Adenovirus or Coxsackie A virus
Respiratory infection
Fever
Headache
Dizziness
Painful Neck
Lymphocytic Leukemoid Reaction
Increase in WBCs and Lymphs
Extreme response to viral infection
Reactive and immature lymphs
Plasmacytosis
Plasma cells (make up 4% of Bone Marrow)
Mott Cell with Russell Bodies
Flame Cells
Infectious Mononucleosis
Epstein-Barr Virus
14-24 yr olds
Infects B-cells
Many reactive lymphs
Monospot Test
Cytomegalovirus (CMV)
Herpes group virus
Most common viral infection
Dangerous to newborns
Lymphocytopenia
Inability to mount response to infection
Steriods
Acute inflammation infections
Cancer
SLE
Chemotherapy/radiation
Malnutrition
Acquired Immune Deficiency Syndrome
Pancytopenia
Decreased lymphocytes
Decreased Th cells (CD4)
Severe Combined Immune Deficiency Syndrome (SCIDS)
Deficiency of T and B cells
Decreased lymphoid tissue in nodes and bone marrow
Recurrent infection
Rash
Failure to Thrive
Death to overwhelming sepsis within 2 yrs of life
Wiskott-Aldrich Syndrome
Decreased antibodies
Eczema, thrombocytopenia, immune deficiency
Death by age 10 due to infection/bleeding
DiGeorge Syndrome
Decreased T cells and lympoid tissue
Normal B cells
No thymus (hypoparathyroidism)
Heart defects, hypocalcemia
Bruton’s Disease
Agammaglobulinemia
Decreased B cells and plasma cells
Normal T cells
Respiratory and skin infections with pyogenic bacteria
LAP scores
CML <13
Normal, healthy 13 - 130
Leukomoid Reaction >160
