Flashcards in Chapter 13 - White Blood Cell Disorders Deck (101)
What do qualitative WBC defects refer to?
Qualitative WBC defects: structure and/or function
Give an example of a disease with a WBC structure defect.
Structure defect: Chédiak-Higashi syndrome
Give two examples of WBC function defects.
Function defect: selectin deficiency, CD11a/CD18 deficiency
Give an example of a WBC phagocytosis defect.
Phagocytosis defect: Bruton agammaglobulinemia
Give two examples of WBC microcidal defect.
Microbicidal defect: MPO/NADPH oxidase deficiencies
What are the clinical findings in qualitative WBC defects?
Qualitative WBC defects: unusual pathogens, “cold” abscesses, frequent infections
What is Job syndrome?
Job syndrome: defect in chemotaxis; ↑IgE
What is the equation to determine the absolute count of WBC?
Absolute count = % leukocytes × total WBC count
What is a leukemoid reaction?
Leukemoid reaction: benign, exaggerated WBC response
What is leukoerythroblastosis?
Leukoerythroblastosis: immature WBCs/nucleated RBCs in peripheral blood
What are the causes of leukoerythroblastosis?
Causes: infiltrative disease; metastasis; granulomatous disease; leukemia
Other causes: trauma with multiple fractures; EMH
What is the probable diagnosis if a woman >50 years presents with leukoerythroblastosis?
Leukoerythroblastosis in woman >50 yrs: probable breast cancer metastatic to bone
How is neutrophilic leukocytosis defined?
Neutrophilic leukocytosis: >7500 cells/mm3
What are the causes of neutrophilic leukocytosis?
Causes: bacterial infection, sterile inflammation with necrosis, corticosteroids
Describe the pathogenesis of neutrophilic leukocytosis.
Pathogenesis: ↑production, ↓activation neutrophil adhesion molecules
How is neutropenia defined?
Neutropenia: <1500 cells/mm3
What are the causes of neutropenia?
Causes: aplastic anemia, immune destruction (SLE), septic shock
Causes: drugs (penicillin), tick-borne diseases, viral infections
Causes: bacterial infection (TB, typhoid, brucellosis); systemic fungi; ionizing radiation
Describe the pathogenesis of neutropenia.
Pathogenesis: ↓production, ↑destruction, ↑activation neutrophil adhesion molecules
How is eosinophilia defined?
Eosinophilia: >400 cells/mm3
What are the causes of eosinophilia?
Causes: type I HSR, invasive helminths, D. fragilis, hypocortisolism
What is a cause of eosinopenia?
Which disease should be considered if basophilia is present?
Basophilia: consider myeloproliferative disease
How is lymphocytosis defined?
Lymphocytosis: >5000 cells/mm3 (adult); >8000 cells/mm3 (child)
What are the causes of lymphocytosis?
Causes: viruses (mononucleosis, CMV), bacteria (whooping cough, TB)
Causes: drugs (phenytoin, tetracycline); Graves disease, CLL
What are the causes of atypical lymphocytosis?
Atypical: infection (mononucleosis, CMV, toxoplasmosis, viral hepatitis); drugs (phenytoin)
Describe the pathogenesis of atypical lymphocytosis.
Atypical lymphocytes: antigenically stimulated
What causes mononucleosis?
Describe the pathogenesis of mononucleosis.
B cells have CD21 receptor sites for EBV; atypical B cells
Mono: cytotoxic T cells control infected B cells; atypical lymphocytes
Mono: EBV dormant in B cells; relapses may occur
What are the clinical findings of mononucleosis?
Mono: fatigue; exudative tonsillitis/petechiae in posterior palate; tender hepatosplenomegaly
Mono: painful lymphadenopathy; pruritic rash with ampicillin/amoxicillin