Presentation on theme: "WHITE BLOOD CELLS and the differential count"— Presentation transcript:
1WHITE BLOOD CELLS and the differential count RAMLA A. SANDAG – JAILANI , M.D.DEPARTMENT OF PHYSIOLOGYKKUH / KSU
2White Blood Cells (WBC) or Leucocytes – are the mobile units of the body’simmune defense system.– formed partially in the bone marrow andpartially in the lymph tissue.
3Leukocytes divide in two categories: A. Polymorphonuclear Granulocytes- neutrophils- eosinophils- basophilsB. Mononuclear Agranulocytes orLymphoid cells- lymphocytes- monocytes
4* Specific Functions:Granulocytes } … protect the body againstinvading organisms mainly byMonocytes } ingesting them ( Phagocytosis )Lymphocytes } … function mainly in connectionwith the immune system
5Normal WBC count: (both male and female) = 4 – 11 x 10³/mm³*Leukocytosis - > 10,000/mm³*Leukopenia - < 4,000/mm³
6NEUTROPHILS ( Polys, Segs, PMNs) – are very active in phagocyting bacteria– most numerous of the WBCs (50 – 70 % of thetotal leukocytes)– primary defense against infection.– are present in large amount in the pus of wounds.Bands / Stabs– immature forms of neutrophils seen as anearly response to infection.
7Neutrophils (cont.)…Neutrophilia- increase in the number of neutrophils- causes:> acute infection- appendicitis, smallpox or rheumatic fever.> acute inflammation- after a heart attack, burnsNeutropenia- decrease in the number of neutrophils- cause:> viral infection - influenza, hepatitis, rubella.
8Neutrophils (cont.)…A neutrophil has very tinylight staining granules(the granules are verydifficult to see).The nucleus is frequentlymulti-lobed with lobesconnected by thin strandsof nuclear material.These cells are capableof phagocytizing foreigncells, toxins, and viruses.
9EOSINOPHIL S – attack parasites and phagocyte antigen-antibody complexes.– account for less than 5% of the WBC’s.– modulate allergic inflammatory responses.Eosinophilia – increase amount of eosinophils– may be due to parasitic diseases, bronchialasthma or hay fever.Eosinopenia – decrease amount of eosinophils– may occur when the body is severely stressed.
10Eosinophils (cont.)…This granulocyte has largegranules (A) which are acidophilicand appear pink (or red) in astained preparation.The nucleus often has two lobesconnected by a band of nuclearmaterial.The granules contain digestiveenzymes that are particularlyeffective against parasitic wormsin their larval form.
11BASOPHIL S – secrete anti-coagulant and vasodilatory substances as histamines and serotonin.– represent less than 0–1% of all leukocytes– main function:> secreting substances which mediate thehypersensitivity reaction.
12Basophils (cont.)…Basophilia - an abnormally high number of basophils.> may be associated with:- hemolytic anemia or chicken pox- radiation exposureBasopenia (Basocytopenia) – decrease numberof basophils.> causes:- urticaria- stress- prolonged steroid therapy
13Basophils (cont.)…The basophilic granules inthis cell are large, stain deepblue to purple, and are oftenso numerous they mask thenucleus.These granules containhistamines (cause vasodilation)and heparin (anticoagulant).> The nucleus is either bi-lobed ortri-lobed.
14LYMPHOCYTES – are the second most numerous leukocyte. – account for 20 – 40% of the white blood cells.– not only fight infections but also provide immunity tocertain disease.– play an important role in our immune response.*T-lymphocytes act against virus infected cellsand tumor cells.*B-lymphocytes produce antibodies.
15Lymphocytes (cont.)…Lymphocytosis– increase in the number of lymphocytes.– Causes:> Infectious mononucleosis or a chronic infection.> Ulcerative colitis> Measles, Mumps, CMVLymphocytopenia– decrease number of lymphocytes.– causes:> Chemotherapy, radiation, aplastic anemia> CHF, SLE, renal failure
16Lymphocytes (cont.)…The lymphocyte is an agranularcell with very clear cytoplasmwhich stains pale blue.Its nucleus is very large for thesize of the cell and stains darkpurple.This cell is much smaller thanthe three granulocytes (which areall about the same size).
17MONOCYTES – the largest of the leukocytes. – account for 2 – 6% of all leukocytes.–These cells leave the blood stream (diapedesis) tobecome macrophages.– As a monocyte or macrophage, these cells arephagocytic and defend the body against virusesand bacteria.
19The nucleus is most often "U" or kidney bean shaped;the cytoplasm is abundantand light blue (more bluethan this micrographillustrates).
20*What is the WBC/ Leukocyte Differential Count? > Determines the number of each type of white bloodcell present in the blood.> Can tell you what type of infection is present.N⁰ values:Neutrophils = 50 – 70%Eosinophils = – 4%Basophils = – 1%Lymphocytes = 20 – 40%Monocytes = – 6%
22* What is Erythrocyte Sedimentation Rate? > It is the rate at which erythrocytes settle in a citratedsample of blood in a specific time period, usuallyone (1) hour.> Is a nonspecific test used to help detect conditionsassociated with acute and chronic inflammation.
23Sedimentation occurs when the erythrocytes clump or aggregate together in a column-likemanner , like “pile of coins”.→ROULEAUX FORMATION
242 Commonly used methods of ESR determination: 1. Wintrobe method 2 * 2 Commonly used methods of ESR determination: Wintrobe method Westergren method – mostly used * Reagents and Apparatus: Westergren’s sedimentation apparatus Anticoagulant (EDTA) Disposable sterile syringes and needles
25Procedure:> To perform the test, anticoagulated blood is placed in an upright tube, known as a Westergren tube, and the rate at which the red blood cells fall is measured and reported in mm/h.
26Normal results:After 1 hour:males = 3 – 5 mm females = slightly higher After 2 hours:males = 7 – 15 mm females = slightly higher
27*Increase ESR is seen in: > Rheumatoid Arthritis (RA), gouty arthritis> Polymyalgia rheumatica> Temporal arteritis> Pregnancy(3rd month to 3 weeks’ postpartum)> Drugs- Dextran- Methyldopa- Oral contraceptives- Theophylline- Vitamin A
29* Clinical uses: 1. It is helpful in diagnosing two specific inflammatory diseases, temporal arteritis andpolymyalgia rheumatica It is used to monitor disease activity andresponse to therapy in both of these diseases It is a prognostic test.* A rising ESR can mean an increase ininflammation or a poor response to a therapy;a decreasing ESR can mean a good response.