Post on 07-Apr-2018
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LeukocytesWhite Blood Cells
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Formation of WBCs
Leukocytes are formed in the redmarrow of many bones.
They can also be formed in lymphatictissue.
They live for about 13-20 days.
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Myelocytic
Maturation SeriesMyeloblast
PromyelocyteMyelocyte
Metamyelocyte
Band Neutrophil
Segmented Neutrophil
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Myelopoeisis
HSC: hemopoeitic stem cell, HPG: hemopoeitic progenitor cells,
CMP: committed myeloid progenitor cell, CLP: committed lymphoidprogenitor cells, CFU: colony forming unit
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White Blood Cells
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WBC Numbers Doctors look at WBC numbers. If number goes up there is some kind
of infection .
Clinics will count the number ofWBCs in a blood sample, this iscalled differential count.
A decrease in the number of white
blood cells is leukopenia. An increase in the number of white
blood cells is leukocytosis.
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White Blood Cells
Per l blood Per l of blood
Total WBC count 5,000 10,000
Neutrophils 50 - 70% 2,000 7,000
Lymphocytes 20 - 40% 1,000 4,000
Monocytes 1 6% 50 600
Eosinophils 1 5% 50 500
Basophils 0 2% 0 - 100
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WBCs Five Types Classified according to the presence
or absence of granules and the
staining characteristics of theircytoplasm.
Leukocytes appear brightly coloredin stained preparations, they have anuclei and are generally larger insize than RBCs.
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Type of WBCs
Granulocyteshave largegranules in their cytoplasm
Neutrophils
EosinophilsBasophils
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Granulocytes Eosinophils
Large, numerous granules
Nuclei with two lobes
2-5% of WBC count
Found in lining of respiratory and digestivetracts
Important functions involve protectionsagainst infections caused by parasitic worms
and involvement in allergic reactions Secrete anti-inflammatory substances in
allergic reactions
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Granulocytes
Basophils
Least numerous--.5-1%
DiapedesisCan leave blood vesselsand enter tissue space
Contain histamineinflammatory
chemical
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Granuloctyes
Neutrophils Stain light purple with neutral dyes
Granules are small and numerouscourse appearance
Several lobes in nucleus 65% of WBC count
Highly mobile/very active
Diapedesis
Can leave blood vesselsand enter tissue space
Phagocytosis (eater), contain severallysosomes
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Types of WBCs
Agranulocytesdo not havegranules in their cytoplasm
Lymphocytes
Monocytes
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Agranulocytes Lymphocytes
Smallest WBC
Large nuclei/small amount of
cytoplasm Account for 25% of WBC count
Two typesT lymphocytesattackan infect or cancerous cell, B
lymphocytesproduce antibodiesagainst specific antigens (foreignbody)
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Agranulocytes
Monocytes
Largest of WBCs
Dark kidney bean shaped nuclei Highly phagocytic
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White blood cells disorders
I. Leukocytosis
increased number of leucocytic countabove upper range of
normal(11,000/mm3 in adult).
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Neutrophilia Neutrophils > 7.5 x 109/L
1. Acute pyogenic infection2. Tissue damage: Truma or infarction3. Malignancy
4. Myeloproliferative disorders : CML5. Drugs: digitalis, Cortison. Myeloproliferative
disorders (CML)
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NEUTROPHILIA
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Eosinphilia Eosinphils > 4 x109/L ( 0.04- 0.4
X109/L). Causes:
1. Allergic diseases2. parasitic diseases
3. Recovery from acuteinfection4. certain skin diseases5. Drug sensitivity
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Basophilia
Basophils > 0.1 x 109/L(N: o.o1-o.1x109/L).
Causes:Myeloproliferativedisorders (MPD)e.g.CML.
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Moncytosis Monocytes > 0.8x 109/L (N:
0.2-0.8x109
/LCauses: Causes:
Chronic bacterial infectione.g. brucllosis, typhoid.
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Lymphocytosis
RelativeLymphocytosis:
PMN leucocytes aredecreased, so the
lymphocytes arerelatively increased.
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Causes:
1. Viral infection
CMVMeasels
2. Bacterial infection
PertusisBrucellosis
3. Chronic lymphocytic leukemia
4. Lymphoma
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Leucopenia
Decrease in leucocytic count below4000/mm
I. neutropenia:
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2. Infection:
Viral: Hepatitis, HIV
Bacterial: brucellosis
some fungal infections
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Agranulocytosis
Marked reduction of neutrophilsbelow 500/mm.
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Lymphopenia
Lymphocytes
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Infectious Mononucleosis Caused by EBV
Clinical picture: sorethroat, fever,Lymphadenopathy splenomegaly.
Laboratory findings:
Absolute lymphocytosiswith atypical
lymphocytes.
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Neoplastic Proliferation of White Cells
Leukemia
Malignant neoplasm of the
hematopoietic stem cells BM replaced by unregulated,
proliferating, immature neoplastic
cells blood leukemia enterspleen, lymph nodes
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Neoplastic Proliferation of White Cells
Classification of Leukemia
A. According to cell type and state of cellmaturity
Lymphocytic immature lymphocytes and theirprogenators
Myelocytic pluripotent myeloid stem cells andinterferes with maturation of all granulocytes, RBCand platelets
B. Acute or Chronic Acute immature cells (blast)
Chronic well differentiated leukocytes
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Classification of leukemias
Acute Chronic
Myeloidorigin
Lymphoidorigin
Acute MyeloidLeukemia (AML)
Acute LymphoblasticLeukemia (ALL)
Chronic Myeloid Leukemia(CML)
Chronic Lymphocytic Leukemia(CLL)
ALL
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Hematopoieticstem cell
Neutrophils
Eosinophils
Basophils
Monocytes
Platelets
Red cells
Myeloidprogenitor
Lymphoidprogenitor
B-lymphocytes
T-lymphocytes
Plasmacells
nave
ALL
AML
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Acute Leukemia
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Acute Lymphocytic Leukemia (ALL)
Most common leukemia in children(80%)
Treatable and potentially curable Classified according to lymphocytes
and state of maturations
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ALL
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Acute Myleocytic Leukemia (AML)
Acute Non-lymphocytic Leukemia (ANLL)
Most common in adults; >50% 60years old
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Acute Myeloid Leukemia
accumulation of blasts in the marrow
A d i AML
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Auer rods in AML
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Chronic Leukemia
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Classification of CL.
There are two types:
1-chronic myeloid leukemia.
2-chronic lymphoid leukemia.
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Chronic Myeloid Leukemia.
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Definition of CML:
Is a clonal disorder of a pluripotentstem cell and is classified as one ofthe myeloproliferative disorder.
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CML
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CML
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Chronic lymphocytic
Leukemia:
CLL
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CLL
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Splenomegaly & hepatomegaly
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Investigation:
CBC:
Wbc:
Diff:lymphocytosis
Anemia:normocytic normochromic anemia Platelets : thrombocytepenia may occur.
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Good Luck!..