Hematology: Non-malignant Disorders

Hematology: Non-malignant Disorders

Non Malignant WBC Disorders Haema - Non Mal:1 Shashi: 03/00 Haema - Non Mal:2 WBC Histogram: Shashi: 03/00 Haema - Non Mal:3 WBC disorders: Quantitative disorders: Penias & Philias & Malignancies.

Qualitative disorders - function disorders Congenital Lazy leucocyte syndrome. Chronic granulomatous disease Pelger Huet, May Hegglin, Alder-Reilly Chediak-Higashi (penias with giant granules). Acquired Steroids, aspirin, alcohol. diabetes, hypogammaglobulinemia Shashi: 03/00

Haema - Non Mal:4 Leucocytes Lymphocytes Band E Monocytes / Macrophages P Granulocytes Neutrophils Eosinophils Basophils

N L M B Shashi: 03/00 Haema - Non Mal:5 Neutrophils

Count 2.5 - 7.5 x 109/l Granular cytoplasm Transient stay in blood Major phagocytic role Bacterial killing 3-5 lobes of nucleus Shashi: 03/00 Haema - Non Mal:6 Disorders of Neutrophil Neutrophilia

Infection (Bacterial) Inflammatory conditions Neoplasia Metabolic conditions N Uraemia Haemorhage / haemolysis Corticosteroids Marrow infiltration MM

M Baso Haematological malignancies Chronic Myeloid Leukaemia Myeloproliferative disorder CML Shashi: 03/00 Haema - Non Mal:7 Myeloid malignancies Acute Myeloid Leukaemia

(AML M-3) Chronic Myeloid Leukaemia Shashi: 03/00 Haema - Non Mal:8 Disorders of Neutrophil Neutropenia Count < 1.5 x 109/l

Drugs Chemotherapy Viral infection Inherited disorders Morphological abnormalities Pelger-Huet anomaly May-Hegglin anomaly Chediak-Higashi syndrome Shashi: 03/00 Haema - Non Mal:9 Neutrophilia Transiently with stress and exercise by a shift of neutrophils from the marginating pool to the circulating pool.

Infection Toxins: metabolic (uremia), drugs, chemicals Tissue destruction or necrosis: infarction, burns, neoplasia, etc Hemorrhage, especially into a body cavity Rapid hemolysis Shashi: 03/00 Haema - Non Mal:10 Neutropenia

Aplastic anemia Toxins that damage marrow Infection Viral (Hep-B), Mycoplasma etc. marrow infiltration by infections or carcinomas, Radiation therapy Chemotherapy Hematologic malignancies such as leukemias Myeloproliferative disorders Congenital disorders Increased neutrophil destruction as in Splenomegaly, Immune destruction Shashi: 03/00 Haema - Non Mal:11

Lymphocytes Count varies with age 1.5 3.5 x109/l The subset cells are B-cells Antibody mediated immunity T-cells Cell mediated immunity NK cells Shashi: 03/00 Haema - Non Mal:12

Disorders of lymphocytes Benign disorders Lymphocytosis Viral infections Bacterial infections Protozoal infections Lymphopenia Marrow failure (drugs, irradiation) Infections (viral infections) Immune-deficiency syndromes Antibody deficiency Cell mediated immune defiency Combined cell and antibody immune deficiency

Shashi: 03/00 Haema - Non Mal:13 Disorders of lymphocytes Benign disorders Infectious mononucleosis Epstein-Barr virus infection Autoimmune lymphoproliferative syndrome

Shashi: 03/00 Haema - Non Mal:14 Disorders of Lymphocytes Malignant disorders Acute lymphoblastic (ALL) leukemia Chronic lymphocytic leukemia (CLL) Lymphomas Non Hodgkins lymphoma Hodgkins disease ALL

CLL Shashi: 03/00 Haema - Non Mal:15 Lymphocytosis Normally be observed in infants and young children. Acute infections, including pertussis, typhoid, and paratyphoid Infectious mononucleosis, with "atypical" lymphocytosis Viral infections, including measles, mumps, adenovirus, enterovirus, and Coxsackie virus Toxoplasmosis

HTLV I Shashi: 03/00 Haema - Non Mal:16 Lymphopenia Immunodeficiency syndromes, including congenital (DiGeorge syndrome, etc) and acquired (AIDS) conditions Corticosteroid therapy Neoplasia, including Hodgkin's disease, non-Hodgkin's lymphomas, and advanced carcinomas Radiation therapy Chemotherapy Shashi: 03/00

Haema - Non Mal:17 Monocytes Count is 0.2-0.8 x 109/ l Functions Antigen presentation Cytokine production Phagocytosis Shashi: 03/00 Haema - Non Mal:18 Disorders of Monocytes Monocytosis

Benign Chronic bacterial infection Malignant Chronic Myelomonocytic Leukaemia CMML Shashi: 03/00 Haema - Non Mal:19 Monocytosis Infections: such as brucellosis, tuberculosis and rickettsia Myeloproliferative disorders Hodgkin's disease Gastrointestinal disorders, including inflammatory bowel diseases and sprue

Shashi: 03/00 Haema - Non Mal:20 Eosinophils Count 0.2 0.8 x 109/l Bilobed nucleus Phagocytic activity is low Modulation of hypersensitivity and allergic reactions Shashi: 03/00 Haema - Non Mal:21

Disorders of Eosinophil Eosinophilia >0.8 x 109/l Allergic reactions Parasitic infections Malignancy HD, NHL Inflammatory conditions Myeloproliferative disorders Hypereosinophilic syndrome Shashi: 03/00 Haema - Non Mal:22 Eosinophilia

Allergic drug reactions Parasitic infestations - with tissue invasion Extrinsic asthma Hay fever Extrinsic allergic alveolitis ("farmer's lung" Chronic infections Hematologic malignancies: CML, Hodgkin's disease Shashi: 03/00 Haema - Non Mal:23 Eosinopenia, Monocytopenia & Basopenia Acute stress reactions with increased glucocorticoid and epinephrine secretion Cushing's syndrome with corticosteroid

therapy Steroid therapy Acute inflammation Shashi: 03/00 Haema - Non Mal:24 Basophils Count 0.1 0.2 x 109/l Bilobed nucleus Nucleus is hided behind the granules Inflammatory response Basophilia is seen in Myeloproliferative disorders (CML) Shashi: 03/00

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