Download White Blood Cell Disorders

• Course title : Hematology (1)
• Course code : MLHE-201
• Supervisor : Prof.Dr Magda Sultan
Date : 24/10/2013
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Outcome
The student will know :
Total & differential leucocytic count
Absolute & relative counts
Quantitative & qualitative WBC
abnormalities.
White Blood Cell
Disorders
White Cell Maturation
Leucocytes (white blood cells)
• Phagocytes
- Granulocytes
.Neutrophils
.Eosinophils
.Basophils
- Mononuclear phagocytic cells
.Monocytes
• Lymphocytes
- B cells & T cells
PB Neutrophils
PB Staff
PB Basophils
PB Eosinophils
PB Monocytes
PB Lymphocytes
White Blood Cell Disorders
Classification :
-Disorders of cell number
Terminology:
.cytosis/philia (increase in number)
.cytopenia (decrease in number)
-Disorders of function & morphology
Normal Total Leucocytic Count
For an adult ( male or female)
Normal reference range:
4,000 – 11,000 / cmm
Relative vs Absolute values
• Total White Blood Cell Count (TWBC)
• Differential count : gives the relative
percentage of each white blood cell.
• Absolute value : gives the actual
number of each white blood cell/cmm.
Calculation
Absolute Count = TWBC x Percent
eg: If TWBC = 6,000 /cmm
Neutrophils = 60 %
So Absolute neutrophilic count =
6,000 x 60 / 100 = 3,600 /cmm
Disorders of Cell Number
• Leucocytosis :
an increased number of leucocytes
in the peripheral blood >11,000 /cmm
• Leucopenia :
a reduced white cell count
( < 4,000 /cmm )
Leucocytosis
• Causes :
- Neutrophilia ( commonest cause ).
- Eosinophilia .
- Basophilia .
- Lymphocytosis .
- Monocytosis .
Neutrophilia
Definition :
Increase in the number of neutophils
and/or its precursors > 7,000/cmm
Causes of Neutrophilia
• Infections (pyogenic bacteria)
• Inflammations produced by :
Toxins,infectious agents,neoplasms
or burns .
• Following haemorrhage.
Reactive changes :
Left shift , toxic granulation , high LAP score.
Causes of Neutrophilia (cont.)
• Chronic granulocytic leukaemia
• Other myeloproliferative disorders
Diagnosis :
Low LAP score .
Philadelphia chromosome .
PB Neutrophilia
Left Shift
Left Shift
High LAP Score
Eosinophilia
• Definition :
An increase in the total number of
eosinophils in the peripheral blood
more than 400/cmm .
If eosinophilic count is > 600/cmm
further investigations are required.
Causes of Eosinophilia
• Allergy
Atopic ,drug sensitivity & pulmonary
eosinophilia .
• Infections
Parasites ,recovery from infection
• Malignancy
Hodgkin’s disease , NHL & MPD
• Skin disorder
• Drugs
• GIT disorders
• Hypereosinophilic syndrome
Eosinophilia
Basophilia
• Definition
Increased basophils in the peripheral
blood > 100/cmm
- Most commonly associated with:
.Hypersensitivity reactions to drugs or food
.Inflammatory conditions e.g RA,ulcerative
colitis.
.Chronic myeloid leukaemia & MPD
Basophilia
Lymphocytosis
• Definition :
An increase above normal in the number
of circulating lymphocytes ( > 4,000/cmm)
Causes of Lymphocytosis
• Acute infections: Infectious mononucleosis,
acute infectious lymphocytosis,mumps,
rubella,pertussis .
• Chronic infections: tuberculosis,syphilis,
brucellosis,infectious hepatitis .
• Thyrotoxicosis (usually only relative)
• Chronic lymphocytic leukaemia
Lymphocytosis
Infectious Mononucleosis
• Caused by Epstein-Barr Virus (EBV)
• Bood picture shows leucocytosis with
absolute lymphocytosis and increased
number of atypical lymphocytes .
• Diagnosis :
- Monospot test .
- EBV serology .
Infectious Mononucleosis
Monocytosis
• Definition :
A monocytosis is present when the
peripheral monocyte numbers rise
above 800/cmm .
Causes of Monocytosis
• Chronic bacterial infections :
tuberculosis,bacterial endocarditis,
brucellosis.
• Other infections :malaria,Kala-azar,
trypanosomiasis,typhus……..
• Hodgkin’s disease .
• Monocytic & myelomonocytic leukaemia
Monocytosis
Leucopenia
• Total white blood count lower than the
reference range for age is defined as
leucopenia ( < 4,000/cmm for an adult )
• The major contribution to a leucopenia
usually comprises a reduction of PB
neutrophils .
Causes of Leucopenia
• Infections :
-Viral as infectious hepatitis,influenza,
rubella and others .
-Bacterial as typhoid fever,brucellosis,
miliary TB .
-Rickesttial and protozoal infections .
• Drugs :
Selective neutropenia,Agranulocytosis,
Aplastic anaemia
Causes of Leucopenia(cont.)
• Megaloblastic anaemia
• Hypersplenism
• Leucoerythroblastic anaemia(Multiple
Myeloma,metastatic carcinoma….)
• Acute leukaemia
• Myelodysplasia
• Aplastic anaemia
Causes of Leucopenia(cont.)
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Cyclical neutropenia
Chronic idiopathic neutropenias
Paroxysmal nocturnal hemoglobinuria
Ionizing radiation & cytotoxic drugs
Miscellaneous conditions :
myxoedema,anaphylactoid shock,
hypopituitarism & SLE
• Student name :
Title :
Training Questions :
Mention the different causes of leucocytosis
How to calculate the absolute count?
Define neutrophilia.
Reference book:
-Essential Hematology .
-Dacie
‫‪Student name :‬‬
‫‪Assignement :‬‬
‫حميد عبد االله حميد مجيد‬
‫دعاء السعيد رشاد قطب‬
‫دينا داود وليم داود‬
‫دينا عبد الرافع عبد الرازق‬
‫رامي رافت لطفي عيسي‬
‫رانيا محمد احمد الشرقاوي‬
‫رحاب سعد محمد قمري‬
‫رحاب محمود شاكر محمدين‬
‫رحمه مسعد عبد اللطيف غنيم‬
‫رشاد ابراهيم رشاد عبد هللا فراج‬
‫‪Quantitative white cell disorders.‬‬
‫رضوي محمد محمود ابراهيم درويش‬
‫رنا فتحي ابراهيم محمد الزمراني‬
‫روزاليين راوبين يعقوب فرج‬
‫ريهام السيد فريج النحراوي‬
‫ريهام سامي كمال الحناوي‬
‫ريهام مصباح علي محمد بركه‬
‫زيد ليث نصيف جاسم‬
‫ساره ربيع عسران يوسف‬
‫سامح زكريا عباس ياسين‬
‫سامر محمد احمد عمران‬
‫‪Eosinophils .‬‬