Nonmalignant disorders of leukocytes Flashcards
what is the pathophysiology of the EBV and how does it affect the WBC blood picture?
the virus infects B cells, and T cells attack these infected B cells; Lymphocytes will be >50% of the WBC diff, with 20% being reactive T cells
What test is used to help initially evaluate for EBV, who is not as sensitive in, and what is the confirmatory test?
heterophile anitbodies; often fals negative in young kids, and fals pos in older ppl bc these antibiodies not specific just to EBV; confirm with VCA, viral capsid antigen test (by ELISA usually?)
What virus causes similar symptoms to EBV, and cna actually cause the same “illness”; How is it diff in diagnosis?
CMV; both can cause Infectious mono; CMV is neg for the heterophile antibodies
When does a “left shift” occur and how is it different from the increase seen in CML?
Occurs as a response by bone marrow to infection or inflammation by releasing more neurophils into circulation, mostly limited to bands and metamyelocytes; In CML you would see more myelocytes and promyelocytes, and blasts.
LAP is also increased in a left shift, but decreased in CML
WHat is a leukemoid reaction?
reactive changes due to infection: toxic granulation, dohle bodies, cytoplasmic vacuolization
What disorder has inclusions resembling dohle bodies? what is this disorder?
May-Hegglin: hereditary anomaly, often asymptomatic with larger blue inclusions (dohle are smaller); also associated with thrombocytopenia and giant platelets , sometimes neutropenia–> in severe cases can cause bleeding; usually asymptomatic
Describe Chediak-higashi syndrome
rare autosomal-recessive disease featuring recurrent bacterial infections, oculotaneous albinism, and GIANT LYSOSOMAL primary GRANULES in many of the cell types (grans, lymps, macrophages, monos,,,,) There is defective chemotaxis and granulation, thus susceptible to bacteria.
Describe CGD, chronic granulomatous disease
hereditary disorder often X-linked, causing failure of respiratory burst in neutros= no superoxide! presents in 1st year with severe bacterial infection often deep tissue (bone, pulmonary, liver abscesses, lymphadenitis, infected rashes….formation of granulomas that keep organisms localized
how is CGD diagnosed?
NBT nitroblue tetrazolium assay or flow cytometry to eval the respiratory burst
Name the qualitative neutrophil disorder associated with mucopolysaccharidoses
Alder-Reilly anomaly, is functionally normal and must be diff’d from toxic granulation
how do Pelger-huet cells appear?
hypo or non-segmentation of nucleus in a mature neutrophil; unusually dark and clumped, can be non-lobular/ so one round shape.
