white blood cells Flashcards
explain how to analyse the cause of leucocytosis
How do we distinguish abnormal?
All types or just one?
Blood film: maturity of cells, morphology
Further investigations
- start with history/ examination- eg enlarged spleen
- then HB and platelet count
- then examine blood film, checking for the things above^
causes of neutrophilia
(> 7.5x10^9/l in adults)
- acute bacterial infection- may see toxic granulation
- Inflammation and tissue necrosis (MI, appendicitis)
- Myeloproliferative disorders (chronic myeloid leukaemia)
- Demargination (exercise, extreme stress)
- Corticosteriods
causes of eosinophilia
(> 0.4 x109/l )
- parasitic infections
- atopic allergy eg asthma, eczema
- hodgkins lymphoma
causes of monocytosis
chronic bacterial infections (tuberculosis, brucellosis and typhoid)
Chronic myelomonocytic leukaemia.
cause of Primary lymphocytosis (malignant clonal proliferation)
Lymphocytic leukaemia, or lymphoma.
causes of Secondary reactive lymphocytosis (polyclonal reactive proliferation)
Infection or inflammation.
what must the blood film be examined for in lymphocytosis is identified
When a lymphocytosis is identified in a FBC the blood film must be examined for the presence of:
• A t y p i c a l / r e a c t i v e l y m p h o c y t e s s e e n i n mononucleosis syndromes.
• Immediate response to acute stress (e.g. heart attack or other severe pain).
• Small lymphocytes and smudge cells seen in chronic lymphocytic leukaemia.
• Primitive blasts seen in acute lymphoblastic leukaemia.
how to spot the difference between primary and reactive lymphocytosis
- clinical picture: age
- Monoclonal or polyclonal: monoclonal b cells only present one light chain- often primary
- mature or immature: immature may be due to a lymphoproliferative disorder
- abnormal forms: eg smear or blast cells seen in lymphoproliferative disorder or atypical as seen in mononucleosis
