quantitative non-malignant leukocyte disorders

Question 1

• Absolute count: <1.75 –1.80 x 10 9/L
• Most common type of leukopenia
• Drugs—cancer chemotherapy, chloramphenicol, sulfas/other antibiotics, phenothiazines, benzodiazepine, antithyroids, anticonvulsants, quinine, quinidine, indomethacin, procainamide, thiazides, Radiation
• Toxins—alcohol, benzene compounds
• Intrinsic defects—Fanconi’s, Kostmann’s, cyclic neutropenia, Chédiak-Higashi
• Immune-mediated—collagen vascular disorders, RA, AIDS
• Hematologic—megaloblastic anemia, myelodysplasia, marrow failure, marrow replacement
• Infectious—any overwhelming infection
• Others—starvation, hypersplenism

AGRANULOCYTOSIS
* Infantile: Kostmann’ssyndrome

Answer 1

neutropenia

Question 2

• Absolute lymphocyte count in:
• Adults: >4.0x109/L
• infants and young children: >9.0x109/L
• CMV-resembles RS cells
• Infectious—many viral, pertussis, tuberculosis, toxoplasmosis, rickettsial
• Chronic inflammatory—ulcerative colitis, Crohn’s
• Immune mediated—drug sensitivity, vasculitis, graft rejection, Graves’, Sjögren’s
• Hematologic—ALL, CLL, lymphoma
• Stress—acute, transient

Answer 2

lymphocytosis

Question 3

• absolute count: >0.3 x 10 9/L
• Myeloproliferative disease
• Allergic—food, drugs, foreign proteins
• Infectious—variola, varicella
• Chronic hemolytic anemia—especially post splenectomy
• Inflammatory—collagen vascular disease, ulcerative colitis

Answer 3

basophilia

Question 4

• absolute count: >0.7 x 10 9/L
• Allergic—urticaria, hay fever, asthma
• Inflammatory—eosinophilic fasciitis, Churg-Strauss syndrome
• Parasitic—trichinosis, filariasis, schistosomiasis
• Nonparasitic infections—systemic fungal, scarlet fever, chlamydial pneumonia of infancy
• Respiratory—pulmonary eosinophilic syndromes (Löffler’s, tropical pulmonary eosinophilia), Churg-Strauss syndrome
• Neoplastic—CML, Hodgkin lymphoma, T cell lymphomas
• diopathichypereosinophilicsyndromes—affecting heart, liver, spleen,CNS, other organs
• Others—certain drugs, hematologic and visceral malignancies, GI inflammatory diseases, sarcoidosis, Wiskott-Aldrich syndrome

Answer 4

eosinophilia

Question 5

• absolute count: >0.9 x 10 9/L
• Infectious—tuberculosis, subacute bacterial endocarditis, syphilis, protozoan, rickettsial
• Recovery from neutropenia
• Hematologic—leukemias, myeloproliferative disorders, lymphomas, multiplemyeloma
• Inflammatory—collagen vascular disease, chronic ulcerative colitis, sprue, myositis, polyarteritis, temporal arteritis
• Others—solid tumor, immune thrombocytopenic purpura, sarcoidosis

Answer 5

monocytosis

Question 6

• absolute count: >7-8 x 10 9/L
• Acute inflammatory—collagen vascular, vasculitis
• Acute infectious—bacterial, some viral, fungal, parasitic
• Drugs, toxins, metabolic—corticosteroids, growth factors, uremia, Ketoacidosis
• Tissue necrosis—burns, trauma, MI, RBC hemolysis
• Physiologic—stress, exercise, smoking, pregnancy
• Neoplastic—carcinomas, sarcomas, myeloproliferative disorders

Answer 6

neutrophilia