October 6, 2015 - Reactive Lymphocytosis Flashcards Preview

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Flashcards in October 6, 2015 - Reactive Lymphocytosis Deck (11):
1

Reactive Lymphocytosis

A polyclonal proliferation of T-cells, almost always due to infection. The absolute lymphocyte count is in excess of 4x109 / L

2

Lymphocyte Populations in the Blood

T-cells (CD3+) is around 75%

B-cells (CD20+) is around 15%

NK-cells (CD56+) is around 5%

3

Relative Proportion of T-Cell Subtypes

Helper T-cells (CD4+) is around 70%

Cytotoxic T-cells (CD8+) is around 30%

4

Reactive Lymphocytosis Presentation

Classic presentation is symptoms similar to that of mono.

- Fever, chills, night sweats

- Cough (non-productive)

- Headache and muscle aches

- General malaise and loss of appetite

- Photophobia

- Ras

5

Reactive Lymphocytosis on PE

The patient may have...

- Pharyngitis

- Meningismus

- Rash

- Jaundice

- Lymphadenopathy (tender)

- Hepatomegaly / splenomegaly

- SOB

6

DDx of Reactive Lymphocytosis

EBV

CMV

Rubella

Mumps

Pertussis (whooping cough)

Infectious hepatitis

HIV seroconversion

Also could be drug-related, stress, or post-splenectomy.

7

Mononucleosis Presentation

Fever

Tender lymph nodes

Fatigue (often long duration)

May have palpable splenomegaly

May have hepatitis

Typical age is the teens/early 20's

8

Reactive Lymphocytosis and Neoplasism

You must rule out a neoplastic cause.

This can often be done by gathering a thorough history, performing an in-depth physical exam, and potentially ordering labwork.

9

Pertussis Presentation

Lengthy respiratory infection around 6 weeks

Gram negative bacillus

Rhinorrhea, congestion, sneezing, and a hacking cough

Leukocytosis (15-100)

Normal, small-appearing lymphocytes on PBS

10

Rubella Presentation

Congenital rubella is the most feared complication where virtually all organs are involved, along with permanent motor damage and mental retardation.

Lymphadenopathy, maculopapular rash, and fever.

Can culture the virus and detect antibodies.

11

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