Chapter 10 Abnormalities of WBCs Qualitative, Quantitative, & Lipid Storage Disease

Decreased Eusinophils

Acute infections , Adrenocorticotropic hormone (ACTH) , Bone marrow aplasia

Increased Monocytes

Chronic infections (TB) , malignancies, leukemia with strong monocytic content, bone marrow failure .

Alder's Anomaly ( Alder-Reily Anomaly)

Genetic anomaly associated with the presence of coarse, dark granules in all cell lines of WBCs. Granulation is due to lipid deposits in the cytoplasm due to DECREASED MUCOPOLYSACCHARIDE production .

Decreased Lymphocytes

HIV, Malnutrition , Chemotherapy , Radiotherapy , Renal failure .

Increased Lymphocytes

Hepatitis viral infection , HIV (human immondefiency Virus) , Chronic bacterial infections, autoimmune disorders, drugs .

Toxic Granulation

More prominent ( large) granules in segmented and bands in direct responses to enhanced lysosome enzyme production. *Granules not on nucleus only on cytoplasm . (neutrophils )

In an HIV infection the level of CD4 lymphocytes is drastically_________.

Reduced

Lipid Storage Disorders

This group of disorder shows a Missing Strategic Metabolic Enzyme or Inactive in the WBCs . (usually due to a single gene deletion )

* "osis" Or "philia" suffix means ?

a cell line is increased (ex: leukeocytosis or esinophilia )

HGA

- Anaplasma phagocytophilum -Mid- Western U.S. -Acute onset high fever, chills, and headaches .

HME

-Ehrlichia chaffeensis -Southwestern and Mid-Atlantic U.S -Flu-like symptoms

Toxic Vacuolization

-Large and small vacuoles in cytoplasm. -prognostic indicator , increased phagocytic activity. 10% of neutrophils affected

Three of the most common Lipid storage Diseases are:

1. Gaucher's Disease 2. Tay-Sachs Disease 3. Niemann-Pick Disease

Two Varieties of human Ehrlichiosis

1. Human Monocytic Ehrlichiosis (HME) 2. Human Granulocytic Anaplasmosis (HGA)

The normal CD4:CD8 ration is

2:1

Peripheral smear usually shows a Reactive Lymphocytosis with _____ to _____ % reactive lymphocytosis .

10, 60

Pelger-Huet Anomaly

Inherited disorder that shows Hyposegmentation of the neutrophil nucleus.

* Qualitative defects can be ______ or _______.

Inherited or acquired , acquired defect more common.

what time of cells are affected by this virus?

Lymphocytes (T helper lymphocytes, (CD4)

Increased Eosinophils

Skin disease , parasitic disease, transplant rejection, myeloproliferative disorder , Asthma

Decrease Basophils

Steroid treatment , inflammation

Shift to the right

older cells (toxic granules )

Shift to the left

younger cells (bands)

Decreased Monocytes

Autoimmune process, Hairy cell leukemia

Chediak-Higashi Syndrome

Autosomal disorder of neutrophil granules . Cytoplasmic granules are gian purple- gray Lymphocytes and monocytes may also show a single large granule. *The anomaly possibly is a Defective fusion protein that is crucial to Lysosomal secretion. *WBCs are Not fully functional and show Reduced chemotaxis and bacterial killing function. *Affected children show neutropenia , albinism , photophobia and developed recurrent infections with Staphyloccus aureus.

Bacterial and other unexpected WBC changes

Bacterial present in blood stream indicates sepsis (bacteremia) a severe condition. Intra and extracellular bacterial must be recognized in a peripheral blood smear and the health-care provider alerted ASAP.

Pyknosis

Changes is seen in degenerated neutrophils as the segmented nucleus becomes an amorphous , smooth , bloqlike structures with no clear segmented structure. These cells are not Counted in the WBC peripheral smear .

Decreased Neutrophils

Drugs ( chloramphenicol), Chemotherapy , infectious disease , Autoimmune disease .

Human Ehrlichiosis

Ehrlichiosis and anaplasmosis tick-borne infections could show a notable WBC inclusions.

HIV/AIDS

Human Deficiency Virus is the agent that causes AIDS

Increased Neutrophils

Infections bacterial, inflammatory response, stress response, malignancy , surgery, physician condition (heat, cold, shock), Drugs.

Dohle Bodies

Light blue patches in cytoplasm of neutrophils (Ribosomal RNA ) cytoplasmic inclusion may appear

Gaucher's Disease

Missing enzyme B-Glucocerebrosidase Autsomal recessive resisting in a single-gene mutation. Abnormal facial features

Tay- Sachs Disease

Missing enzyme Hexosaminidase A Autosomal recessive There is central nervous system involvement in infantile forms and a short life spans prevail.

Niemann-Pick Disease

Missing enzyme Sphingomyelinase Abnormal facial features

May- Hegglin Anomaly (Hereditary)

associated with thrombocytopenia and giant platelets . Dohle bodies are larger than the regular Dohle bodies seen in infection

Infectious Mononucleosis

caused by Eptein-Barr Virus) is the most common disease showing lymphocytosis . Virus enters through the oral route and infects B Lymophycytes. The normal Lymphocytes become infected and transform into Reactive Lymphocytes.

* "penia"

decrease in a number of cells (ex: neutropenia , leukopenia )

* Qualitative Defects of WBCs

happen in the CYTOPLASM or the NUCLEUS

Platelet Satellitism

in a blood smear of some patients which react with EDTA causing platelets to form a ring around neutrophils. Low platelets count

Reactive Lymphocytes

larger than normal with an Abundant royal blue cytoplasm and sometimes Scalloping the red cells. This cells must be recorder separately from the non-reactive normal lymphocytes .

Nuclear Abnormalities

neutrophil having more than five lobes ( hyperhsegmented ) accompanied by oval macrocytosis ( RBCs)Seen in megaloblastic anemia produced by deficiency of B12 and folic acid.