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Formation of WBCs
Leukocytes are formed in the red marrow of many bones. They can also be formed in lymphatic tissue. They live for about 13-20 days.
Myelopoeisis
HSC: hemopoeitic stem cell, HPG: hemopoeitic progenitor cells, CMP: committed myeloid progenitor cell, CLP: committed lymphoid progenitor cells, CFU: colony forming unit
WBC Numbers
Doctors look at WBC numbers. If number goes up there is some kind of infection . Clinics will count the number of WBCs in a blood sample, this is called differential count. A decrease in the number of white blood cells is leukopenia. An increase in the number of white blood cells is leukocytosis.
Per l of blood
5,000 10,000 2,000 7,000 1,000 4,000
Monocytes
Eosinophils Basophils
1 6%
1 5% 0 2%
50 600
50 500 0 - 100
WBCs
Five Types Classified according to the presence or absence of granules and the staining characteristics of their cytoplasm. Leukocytes appear brightly colored in stained preparations, they have a nuclei and are generally larger in size than RBCs.
Type of WBCs
Granulocytes
Eosinophils Large, numerous granules Nuclei with two lobes 2-5% of WBC count Found in lining of respiratory and digestive tracts Important functions involve protections against infections caused by parasitic worms and involvement in allergic reactions Secrete anti-inflammatory substances in allergic reactions
Granulocytes
Basophils
Least numerous--.5-1% DiapedesisCan leave blood vessels and enter tissue space Contain histamineinflammatory chemical
Granuloctyes
Neutrophils Stain light purple with neutral dyes Granules are small and numerous course appearance Several lobes in nucleus 65% of WBC count Highly mobile/very active DiapedesisCan leave blood vessels and enter tissue space Phagocytosis (eater), contain several lysosomes
Types of WBCs
Agranulocytesdo not have granules in their cytoplasm
Lymphocytes Monocytes
Agranulocytes
Lymphocytes Smallest WBC Large nuclei/small amount of cytoplasm Account for 25% of WBC count Two typesT lymphocytesattack an infect or cancerous cell, B lymphocytesproduce antibodies against specific antigens (foreign body)
Agranulocytes
Monocytes
Largest of WBCs Dark kidney bean shaped nuclei Highly phagocytic
Neutrophilia
1. 2. 3. 4. 5.
NEUTROPHILIA
Eosinphilia
Eosinphils > 4 x109/L ( 0.04- 0.4 X109/L). Causes:
1. 2. 3. 4. 5.
Allergic diseases parasitic diseases Recovery from acute infection certain skin diseases Drug sensitivity
Basophilia
Basophils > 0.1 x 109/L (N: o.o1-o.1x109/L). Causes: Myeloproliferative disorders (MPD)e.g. CML.
Moncytosis
Monocytes > 0.8x 109/L (N: 0.2-0.8x109/LCauses: Causes: Chronic bacterial infection e.g. brucllosis, typhoid.
Lymphocytosis
Relative Lymphocytosis: PMN leucocytes are decreased, so the lymphocytes are relatively increased.
Causes: 1. Viral infection CMV Measels 2. Bacterial infection Pertusis Brucellosis 3. Chronic lymphocytic leukemia 4. Lymphoma
Leucopenia
I.
1.
Decrease in leucocytic count below 4000/mm neutropenia: <2000/mm Causes: Drugs: anti inflammatory anti bacterial anti malarial
2. Infection:
Viral: Hepatitis, HIV Bacterial: brucellosis some fungal infections
Agranulocytosis
Marked reduction of neutrophils below 500/mm.
Lymphopenia
1. 2. Lymphocytes <1500/mm Causes: Irradiation Steroids and Immunosuppressive drugs
Infectious Mononucleosis
Caused by EBV Clinical picture: sore throat, fever, Lymphadenopathy splenomegaly.
Leukemia Malignant neoplasm of the hematopoietic stem cells BM replaced by unregulated, proliferating, immature neoplastic cells blood leukemia enter spleen, lymph nodes
B.
Acute or Chronic
Acute immature cells (blast) Chronic well differentiated leukocytes
Classification of leukemias
Acute Myeloid origin
Acute Myeloid Leukemia (AML)
Chronic
Chronic Myeloid Leukemia (CML)
Lymphoid origin
ALL
nave B-lymphocytes Plasma cells T-lymphocytes
Lymphoid progenitor
AML
Hematopoietic stem cell Myeloid progenitor Neutrophils Eosinophils Basophils Monocytes Platelets
Red cells
Acute Leukemia
Most common leukemia in children (80%) Treatable and potentially curable Classified according to lymphocytes and state of maturations
ALL
Chronic Leukemia
Classification of CL.
There are two types:
1-chronic myeloid leukemia. 2-chronic lymphoid leukemia.
Definition of CML:
Is a clonal disorder of a pluripotent stem cell and is classified as one of the myeloproliferative disorder.
CML
CLL
Investigation:
CBC: Wbc: Diff:lymphocytosis Anemia:normocytic normochromic anemia Platelets : thrombocytepenia may occur.
Good Luck!..