10Functions of White Blood Cells PhagocytosisThe neutrophils and the monocytes engulf foreign particles and bacteria through their phagocytic action, thereby destroying their action.Body defenseWBC manufactures anti-bodies and immune bodies to increase the power of resistance against any infection.Formation of fibroblastLymphocytes may be converted to fibroblasts in the area of inflammation and help the process of tissue repair and regeneration.
11Functions of White Blood Cells Secretion of heparinThe basophile leucocytes are supposed to secrete heparin (a substance of liver), which prevent, intravascular clotting.Anti histamine functionsThe eosinophils are believed to defend the body against allergic conditions in which histamine like bodies are produced in excess.
12Functions of White Blood Cells Production of thromboplastic substancesDue to the production of such substances, the process of coagulation and the deposit of clot are facilitated.Destroy Cancer CellsIn addition to recognizing and killing virally infected cells, T lymphocytescan also target and kill tumor cells or abnormal cells that may represent the early beginnings of a tumor.
20Leukaemoid Reaction or Leucoerythroblastic Anaemia Causes Severe infections, especially in children:a. Pneumonia, septicaemia, meningococcal meningitisb. Infectious mononucleosis, pertussisIntoxications:Eclampsia, severe burns, mercury poisoningNeoplasia:Especially with bone-marrow infiltrationSevere haemorrhage or haemolysis
22Neutropenia Causes (cont…) Hypersplenism:PrimaryIn association with cirrhosis, Felty’s syndrome, etc…Ionizing radiation and cytotoxic drugs:RadiotherapyAlkylating agents, antimetabolites, othersMalignant disease:Acute leukaemiaLeuco-erythroblastic anaemia due to metastatic carcinoma, multiple myeloma or lymphomaMicscellaneous conditions:Systemic lupus erythematosus, myxoedema, hypopituitrism, iron deficiency, anaphylactic shock
23Lymphopenia Causes Loss: Maturation: Pharmacological agents: Mostly from gut as in intestinal lymphangiectasia, Whipple’s disease and rarely Crohn’s diseaseThoracic-duct fistulaMaturation:Primary, or secondary to gut diseaseVit B12 or folate deficiencyZinc deficiencyPharmacological agents:Antilymphocyte globulinCorticosteroidsCytotoxic drugs
24Lymphopenia Causes (Cont…) Infections:Severe septicaemiasInfluenza, occasionally other virus infectionsColorado tick feverMiliary tuberculosisOther miscellaneous conditions:Collagen vascular diseases, especially SLEMalignant diseaseOther conditions with lymhocytotoxinsRadiotherapyGraft-versus-host disease
25Leukocyte Morphological Abnormalities Congenital and Aquired
30CASE 1History:This 20 year old male came to the emergency room with severe abdominal pain in the right lower quadrant. He had a fever of 39 0C. On examination, he had a rigid abdomen & rebound tenderness in the right lower quadrant. There were no other abnormalities.
32CASE 1Urinalysis was within normal limits. A CBC showed Hgb 140 g/l, WBC 25 X 109/L, and platelet count 350 X 109/L.
33What are the WBCs predominantly seen? CASE 1What are the WBCs predominantly seen?Mainly neutrophilsNotice that the WBC count is higher than in a normal smear.In addition a small but increased number of band forms are seen.The platelets are moderately increased in number.
34What is the name for this type of leukocyte reaction? CASE 1What is the name for this type of leukocyte reaction?This reaction is known as neutrophilia.
35What do you think the diagnosis is? CASE 1What do you think the diagnosis is?The diagnosis is acute appendicitis(most, but not all, cases of acute appendicitis are associated with neutrophilia).
36CASE 2History:This 17 year old female was sent home from summer camp because of weakness, lassitude, and sore throat. On examination she was found to have an inflamed pharynx, enlarged tonsils, several enlarged and slightly tender lymph nodes in the neck, a palpable spleen, and a tender palpable liver edge.
38CASE 2CBC showed Hgb 149 g/l, WBC 12.5 X 109/L, and platelet count 282 X 109/L
39What are the WBCs predominantly seen? CASE 2What are the WBCs predominantly seen?The predominant cells are lymphocytes with many atypical lymphocytes.
40CASE 2What is your diagnosis in this case?infectious mononucleosis.
41What is the differential diagnosis? CASE 2What is the differential diagnosis?- Other viral infections including hepatitis and cytomegalovirus.- It should not be confused with leukemia.
42CASE 2What other laboratory test that may be helpful in arriving at a specific diagnosis?serologic test for infectious mononucleosis likePaul-Bunnell (Monospot) test would confirm the diagnosis in most cases.