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Non-Neoplastic WBC disorders


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-Decrease in ABSOLUTE neutrophil count
Normal Neutrophil count
Causes of neutropenia
Decreased BM myeloid production
Increased peripheral utilization
Complications of neutropenia
Acute infections
Causes of decreased BM myeloid production in neutropenia
-Drugs (chemotherapy), Aplastic anemia, Infiltrative BM processe, megaloblastic anemia, myelodysplastic syndrome, radiation
-Congenital agranulocytic syndromes (kostmann syndrome)
Causes of increased neutrophil utilization in neutropenia
Overwhelming bacterial/fungal infections
immuno problems (drug, autoimmune)
Splenic Sequestration
Decreased lymphocyte count
Normal Lymph count
Up to 8000 in children
Causes of Lymphopenia
-Congenital immunodeficiency syndromes (SCID)
-Viral infections (HIV)
-Drugs (steroids, chemo)
-Autoimmune syndromes
-Malnutrition (rare here)
-Acute infections (COMMON)
Increased WBC count-11,000
Can be reactive or neoplastic

Can be due to increase in any one of the white blood cells
Absolute neutrophil count >8000
Most common cause of neutrophilia
-Acute Bacterial Infection (reactive changes)
-Physilogical stress
Reactive changes seen in neutrophilia
-Toxic granulation
-Dohle bodies
Leukemoid reaction
Extreme neutrophilia with immature granulocyte precursors
(left shift) simulationg leukemia
Dohle Bodies look like
light blue spots in the cytoplasm
Immature granulocytes (metamyelocytes or less mature) and nucleated RBC precursors in peripheral blood
Causes of leukoerythroblastosis
Severe acute infection or bleeding

Infiltrative BM processes

Myeloproliferative syndromes (CML)

Extramedullary hematopoeisis
Absolute lymphocyte count >4000 adults, 8000 children
Causes of lymphocytosis
-chronic inflammations
-viral infections
-lymphoid neoplasms, especially CLL
Transformed Lymphocytes
Nonspecific reaction to antigenic stimulation, often seen in viral infections and lymphocytosis
>1000 absolute monocyte count
Causes of monocytosis
-Chronic infection or inflammation
-Recover from neutropenia
-Myelodysplastic/myeloproliferative overlap syndromes
-Absolute eiosinophil count >500
Causes of eiosinophilia
Allergic disorders
Drug effects
Parasitic infections
skin diseases
myeloproliferative syndromes
Absolute basophil count >250
Rare, most often indicates myeloproliferative syndrome (CML)
Pelger-Huet anomaly
Autosomal dominant, asymptomatic, hypolobated pince-nez (pinched nose) forms

can also be acquired in myelodysplastic syndromes
May-Hegglin anomaly
Congenital leukopenia with increased dohle bodies, thrombocytopenia with giant platelets
Alder-Reilly Syndrome
Congenital hypergranulation of ALL wbc's, associated with mucopolysaccharidoses
Chediak-Higashi Syndrome
Congenital giant granulation of all WBC's, associated with albinishm, peripheral neuropathy, neutropenia with frequent infections, bleeding d/t platelet disfunction

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