UNIT 1 - Lecture 9: Neutrophils 2 Flashcards by Bianca Zayas

What are 2 reasons why NPs may shift from MNP to CNP?

Physiologic (epinephrine)
Corticosteroids

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What are 4 mechanisms for neutrophilia?

Shift from MNP to CNP
Increased release from marrow
Increased production
Decreased migration into tissues

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What are 2 reasons why there may be an increased NP release from marrow?

Inflammation
Corticosteroids

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How long does it take for a neutrophilia to be caused by increased production of NPs?

3-6 days

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What 2 things might decrease NP migration into the tissues?

Leukocyte adhesion deficiency
Corticosteroids

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When may we see physiologic neutrophilia during health? What is it due to?

During fear/excitement due to release of epinephrine

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How long after stress/excitement is over do we see NP count return to RI in healthy animals?

within ~1 hour

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Other than NPs, what cell type would we see an increase in due to fear/excitement?

lymphocytes

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What spp do we most often recognize physiological neutrophilia in?

cats

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Physiologic leukocytosis in horses (young foals) is due to _____ and _____.

neutrophilia, lymphocytosis

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When do we see physiologic neutrophilia in healthy cattle? What might they also have?

Parturition, exercise, transport, chutes;

Eosinopenia

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In what spp is physiologic neutrophilia uncommon?

dogs

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When might we see physiologic neutrophilia in pigs? What else might we see?

Lactation, post-prandial;

Lymphocytosis

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In a physiologic leukogram, total WBC count is _____.

increased

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In a physiologic leukogram, segmented NPs are _____.

increased

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In a physiologic leukogram, non-segmented neutrophils are _____.

WRI

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T/F: In a physiologic leukogram, there are several WBC morphology changes.

False;

there are none

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In a physiologic leukogram, lymphocytes are _____.

increased

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In a physiologic leukogram, monocytes are _____ to _____.

WRI to increased

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In a physiologic leukogram, eosinophils are _____.

WRI

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In an inflammatory leukogram, what are the mediators and key cell type?

Mediators = inflammatory, cytokines

Key cell = NPs

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In an inflammatory leukogram with neutrophilia, what are the mediators and what is the key cell type?

Mediators = Inflammtory, cytokines

Key cell = increased NPs

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In an inflammatory leukogram with neutropenia, what are the mediators and what is the key cell type?

Mediators = unmet high demand/toxins

Key cell = decreased neutrophils

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In a leukogram with a left shift, what are the mediators and key cell type?

Mediators = inflammatory, cytokines

Key cell = increased band NPs (can have myelocytes and metamyelocytes as well)

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In a fright/flight leukogram, what is the mediator and key cell types?

Mediator = epinephrine Key cells = **increased** NPs & **increased** lymphocytes

In a "stress" leukogram, what is the mediator and key cell types?

Mediator = cortisol Key cells = **increased** NPs, **decreased** lymphocytes

What are the 2 types of stress neutrophilia due to cortisol?

Endogenous and exogenous

Where are glucocorticoids produced?

In the zona fasciculata of the adrenal cortex

Cortisol, a major \_\_\_\_\_, is a _____ derived from \_\_\_\_\_.

glucocorticoid, steroid hormone, cholesterol

Where are mineralcorticoids synthesized?

zona glomerulosa

What 2 mechanisms cause a stress neutrophilia from cortisol/clucocorticoid release?

1. Increased marrow release of NPs 2. Decreased adhesion molecules

What happens when adhesion molecules are decreased?

1. Shift from MNP to CNP 2. Decreased migration into tissues 3. NPs circulate longer; increase T_1/2 --\> hypersegmented

What spp has the highest corticosteroid-induced neutrophilia?

dogs

What are characteristic findings on a corticosteroid leukogram?

1. Mature neutrophilia (little to no left shift) 2. Lymphopenia 3. Monocytosis (dogs mostly) 4. Eosinopenia

Presence of a corticosteroid leukogram in birds depends on what?

If heterophils of lymphocytes are predominant in that particular spp

In general, what would be characteristics of a corticosteroid leukogram in birds?

Heterophilia and lymphopenia

In a corticosteroid leukogram, total WBC would be \_\_\_\_\_.

increased

In a corticosteroid leukogram, segmented neutrophils would be \_\_\_\_\_.

increased

In a corticosteroid leukogram, non-segmented NPs would be _____ to \_\_\_\_\_.

WRI to minimally increased

In a corticosteroid leukogram, what WBC morphology changes would occur?

+/- hypersegmented PMNs

In a corticosteroid leukogram, lymphocytes would be \_\_\_\_\_.

decreased

In a corticosteroid leukogram, monocytes would be \_\_\_\_\_.

increased

In a corticosteroid leukogram, eosinophils would be \_\_\_\_\_.

decreased

What changes would be seen in a leukogram when there is lack of cortisol due to **hypo**adrenocorticism?

Segmented NPs = Decreased to WRI Lymphocytes = WRI to increased Eosinophils = WRI to increased

What NP changes indicate inflammation (acute, strong NP demand)?

1. Significant left shift 2. Toxic changes

What changes would one expect to see with lymphocytes, monocytes, and eosinophils when there is acute inflammation?

Lymphocytes = increased (WRI if cortisol also involved) Monocytes = increased Eosinophils = increased

At what point is inflammation considered chronic?

\>7-10 days

In chronic inflammation, marrow catches up with demand and will have granulocyte \_\_\_\_\_.

hyperplasia

In chronic inflammation, there will typically be a _____ neutrophilia.

moderate

What are characteristics of chronic inflammation that can be seen on a leukogram?

1. +/- lymphocytosis 2. Monocytosis 3. Eosinophilia and basophilia (dep on cause) 4. +/- left shift, +/- toxic NPs

Why does a left shift typically diminish or resolve over time in chronic inflammation?

Marrow becomes hyperplastic and NP supply can now keep up with demand

In a chronic inflammatory leukogram, total WBCs are \_\_\_\_\_.

increased

In a chronic inflammatory leukogram, segmented NPs are \_\_\_\_\_.

increased

In a chronic inflammatory leukogram, non-segmented NPs are _____ to \_\_\_\_\_.

WRI to increased

In a chronic inflammatory leukogram, what WBC morphology changes might we expect?

+/- toxic changes, +/- reactive lymphocytes

In a chronic inflammatory leukogram, lymphocytes are \_\_\_\_\_.

WRI to increased

In a chronic inflammatory leukogram, monocytes are \_\_\_\_\_.

WRI increased

In a chronic inflammatory leukogram, eosinophils are \_\_\_\_\_.

WRI

What conditions can cause extreme neutrophilia in dogs?

Pyometra, pyothorax, hepatozoonosis, AIHA, canine leukocyte adhesion deficiency (CLAD), paraneoplastic syndrome (CSF release)

How is cat neutrophilia compared to dogs?

Similar response but not as robust (rarely gets to 75,000/µL when dogs can get \>100,000/µL)

Regarding cattle neutrophilia: Cattle have a smaller marrow \_\_\_\_\_.

maturing storage pool

How long can neutrophilia take to show in cattle?

3-6 days

What is associated with cattle neutrophilia and how long does it take before it is apparent?

Increased fibrinogen - takes ~48 hours before you can see an increase

What is significant about calves and NP count?

Newborns have more PMNs than lymphocytes; Increasing LC counts happen @ 6-8 weeks of age; Within 3 months LCs drop to adult intervals

What is the cattle ratio of NP to LC?

NP : LC = 1 : 2

What might one see in acute inflammation in cattle?

1. Leukopenia due to neutropenia and pymphopenia 2. Severe left shift

What might one see in chronic inflammation in cattle?

1. NP counts up to 10,000/µL 2. NPs predominate instead of lymphocytes

What is the horse neutrophilia response like?

NP response to inflammation is moderate

In cattle and horses, what is a more reliable indicator of inflammation than a leukogram?

hyperfibrinogenemia

What methods can be used to assess inflammatory disease in cattle and horses and which one is not very reliable?

1. Plasma protein : fibrinogen ratio - **not reliable** 2. Serum amyloid A (SAA) 3. Haptoglobin

What is happening if cattle plasma protein : fibrinogen ratio is \>15? \<10? 10-15?

\>15 = dehydration \<10 = true increase in fibrinogen --\> inflammation 10-15 = either/both

What is happening if horse plasma protein : fibrinogen ratio is \>20? \<15? 15-20?

\>20 = dehydration \<15 = true increase in fibrinogen --\> inflammation 15-20 = either/both

What diseases are of concern when an avian has an inflammatory leukogram?

Salmonellosis, Mycobacteriosis, Aspergillosis, Chlamydiosis

What is the cause of leukocyte adhesion deficiency?

Inherited lack of ß2 integrins CD18 for adhesion; NPs cannot migrate to tissues due to this

What spp can have leukocyte adhesion deficiency?

bovine (Holstein), canine (Irish Setter)

What are 3 features of leukocyte adhesion deficiency?

1. Extreme neutrophilia - marrow makes more NPs due to infection in tissues but cannot adhere to vessels to exit into tissues 2. Infections with lack of suppuration 3. Animals fail to thrive

What are 4 mechanisms for neutropenia?

1. Shift from CNP to MNP 2. Increased peripheral destruction 3. Decreased production 4. Migration into tissues (increased inflammation)

What are some causes of neutropenia?

1. Inflammation (endotoxemia) 2. Peripheral destruction 3. Ineffective production 4. Cyclic hematopoiesis 5. Granylocytic hypoplasia

Inflammatory neutropenia can be caused by _____ or severe _____ inflammation.

overwhelming, acute

In what spp. is inflammatory neutropenia common and in what conditions?

Adult cattle; Mastitis and pneumonia

What is the effect of an endotoxic neutropenia on PMNs?

Rapid shift from circulating PMN pool to marginating PMN pool.

What 2 things are common in endotoxic neutropenia?

1. NP toxic change 2. Lymphopenia

In an acute overwhelming inflammatory endotoxemia leukogram, total WBC are \_\_\_\_\_.

decreased

In an acute overwhelming inflammatory endotoxemia leukogram, segmented NPs are \_\_\_\_.

decreased

In an acute overwhelming inflammatory endotoxemia leukogram, nonsegmented NPs are \_\_\_\_\_.

increased

In an acute overwhelming inflammatory endotoxemia leukogram, what WBC morphology changes might we see?

toxic changes

In an acute overwhelming inflammatory endotoxemia leukogram, lymphocytes are \_\_\_\_\_.

decreased

What is a common infectious cause for neutropenia?

*Anaplasma phagocytophilum*

What are some RARE causes of peripheral or marrow destruction neutropenia?

Immune-mediated, hemophagocytic syndrome