WBC Abnormalities Flashcards
Increases risk of infection from host organisms
Agranulocytosis
Major causes of neutrophilia
1 Infection
2 Inflammation
3 Malignancy
Released in response to acute infection, trauma or inflammation
Colony-stimulating factor
Causes of leukopenia
1 Viral infections
2 Overwhelming bacterial infections
3 Bone marrow disorders
4 Certain drugs (barbiturates, neurologic drugs, certain antibiotics, anticonvulsants)
What are leukemoid reactions?
Reactive leukocytosis seen in leukemia characterized by blasts, promyelocytes, myelocytes, and metamyelocytes
Presence of nucleated RBCs and immature neutrophils
Leukoerythroblastic reaction
Physiologic cause of neutrophilia
Response to therapy
Causes of leukoerythroblastic reactions
Damage to marrow and extramedullary hematopoiesis (tumor, fibrosis, lymphoma or leukemia)
Neutrophilia is associated with
1 Acute inflammation 2 Acute stress 3 Myelocytic leukemia 4 Eclampsia 5 Gout 6 Autoimmune diseases (rheumatoid arthritis, thyroiditis) 7 Trauma
Two kinds of neutrophilia
Acute shift
Chronic stimulation
Basophilic leukocytosis
Basophilia
Causes of neutropenia
1 Increased neutrophil destruction (overwhelming infection; bacteria such as Typhoid, Paratyphoid, Brucellosis; viruses such as measles, yellow fever, Hepatitis A, IM, Rubella; immune reactions such as isoimmune, autoimmune or drug-induced; other mechanisms such as sequestration, pseudoneutropenia, malignant myeloproliferative disorders)
2 Decreased neutrophil production
Excess cytokine stimulates proliferative pool
Chronic stimulation
Pathologic causes of neutrophilia
1 Infections (pyogenic bacteria, rabies, variola, herpes zoster, chicken pox, Actinomyces fungi, some spirochetal and rickettsial organisms) 2 Inflammatory responses to tissue destruction (serosal, visceral, blood destruction, posttraumatic, thermal injury, chemicals, drugs, venoms, parasitic invasions, autoimmune disorders) 3 Other inflammatory responses (neoplastic growth, metabolic disorders, acute hemorrhage) 4 Drugs (corticosteroids, lithium)
Abnormally low number of neutrophils
Neutropenia
Usually occurs secondary to viral infection
Leukopenia
Presence of precursor granulocytes in the peripheral blood
Shift to the left
T or F. There is an increased total WBC count in acute shift neutrophilia
F. Only measured WBC is increased
Neutropenia is associated with
1 Aplastic anemia 2 Chemotherapy 3 Radiation therapy or exposure 4 Viral infection 5 Widespread severe bacterial infection
Acquired causes of decreased neutrophil production
1 Chemical toxicity due to chemotherapy (ionizing radiation, benzene)
2 Marrow replacement
3 Nutritional deficiency
4 Cytotoxic drugs
Dominance of immature forms of neutrophils in the blood
Left shift
Common in myelofibrosis
Severe disruption of the marrow
Causes of chronic stimulation
1 Infection 2 Down's syndrome 3 Pregnancy/eclampsia 4 Chemotherapy recovery 5 Myeloproliferative disorders 6 Marrow metastasis
Monocytic leukocytosis
Monocytosis
Eosinophilic leukocytosis
Eosinophilia
Two types of causes of decreased neutrophil production
1 Inherited
2 Acquired
Inherited causes of decreased neutrophil production
1 Defective stem cell development (reticular dysgenesis, cyclic neutropenia, infantile agranulocytosis, Fanconi’s syndrome)
2 Genetic disorders of the immune system
3 Disorders of cellular development (Chediak-Higashi syndrome, Lazy leukocyte syndrome)
Presence of bilobed neutrophils with more condensed chromatin
Pseudo-Pelger Huet Anomaly
Affects platelets
May-Heggelin Anomaly
Immunologic neutropenia
Drug-induced
Classification of neutrophil morphologic abnormalities
1 Cytoplasmic morphologic abnormalities
2 Nuclear morphologic abnormalities
Cytoplasmic morphologic abnormalities of neutrophils
1 Toxic granules 2 Dohle bodies 3 May-Heggelin Anomaly 4 Cytoplasmic vacuolation 5 Pseudopods 6 Auer rods
Neutrophilia quantitative abnormalities
Neutrophilia
Neutropenia
Found in segmented and band neutrophils
Dohle bodies
Nuclear morphologic abnormalities of neutrophils
1 Pyknotic nuclei 2 Hypersegmented nuclei 3 Toxic nuclear projections 4 Ringed nuclei 5 Chediak-Higashi syndrome
Most common cause of leukopenia
Neutropenia
Cause of toxic granules
Stimulation by antigens
Produces vacuoles that are large and unevenly distributed
Phagocytosis of extracellular material
Pseudo-Pelger Huet Anomaly is found in
1 Inherited myelodysplastic syndrome 2 Idiopathic myelofibrosis 3 Chronic granulocytic leukemia 4 Therapy with colchicine 5 Ibuprofen infectious mononucleosis 6 Malaria 7 Myxedema 8 Chronic lymphocytic leukemia
Characteristics of dohle bodies
1 Pale blue
2 Round or elongated bodies
3 1-5 mcm located near cell membranes
Inherited condition that causes large Dohle-like inclusion bodies present primarily in neutrophils
May-Heggelin Anomaly
Indicates sluggish neutrophil locomotion
Pseudopods
WBC < 4,000
Leukopenia
Neutrophilia qualitative abnormalities
1 Shift to the left
2 Pelger-Huet
3 Pseudo-Pelger Huet Anomaly
Produces vacuoles that are small and evenly distributed
Autophagocytosis
Characteristics of toxic granules
1 Large
2 Dark blue-black
3 Clustering within the cell
Temporary or transient leukocytosis
Leukemoid reaction
What are dohle bodies?
Cytoplasmic inclusions consisting of rRNA in parallel rows
Chediak-Higashi Syndrome affects
Neutrophils
Monocytes
Lymohocytes
Shift to the left is found in
1 Pregnant women or neonates
2 Infections
3 Bone marrow fibrosis
4 Bone marrow infiltration by malignancies
What are pseudopods?
Granule-free protrusions of cytoplasm
Causes of autophagocytosis
Sulfonamides and chloroquine
Prolonged storage of cells
Increased proportion of toxic granules is associated with
Poor prognosis