White Blood Cell

Protocols

Neutrophilia

Physiological

 In muscular activity
 Infants during first few days
 During last week of pregnancy
 Emotional disturbances
 Extreme heat and cold.

Pathological

• Acute infections due to staphylococcus, streptoco-

ccus, pneumococcus, gonococci and septicaemia,
acute appendicitis, osteomyelitis, etc.
• In intoxications
• Gout, diabetic coma, cirrhosis of liver, intestinal
obstruction, uraemia.
• Myeloid leukaemia
• After acute haemorrhage
• In malignant tumours
• Poisons like carbon monoxide, chloroform, ether
• Myocardial infarction
• Serum sickness.

Causes of Neutropenia:

1.       Infection: Viral ,Bacterial (salmonella),protozoal(eg. Malaria)
2.       Drugs : Carbimazole ,Propylthiouracil,captopril,nifedipine,pyrimethamine,sulphonamides,penicillins,cephalosporins.
3.        Autoimmune : connective tissue disease
4.       Alcohol
5.       Bone marrow infiltration : Leukaemia ,myelodysplasia
6.       Congenital : Kostmann’s syndrome
7.       Constitutional : Afro-caribbean & middle east people

Leucopenia

Infections
Bacterial
Typhoid fever, paratyphoid fever, brucellosis, miliary
tuberculosis.
Viral
Influenza, measles, infective hepatitis.
Protozoal
Malaria, kala azar, relapsing fever.
Defective Bone Marrow Function
Aplastic anaemia
Megaloblastic anaemia.
Bone Marrow Involvement
Secondary carcinoma
Malignant lymphoma
Myelosclerosis
Multiple myeloma.
Sensitivity to Drugs (Agranulocytosis)
Sulphonamides
Thiouracil
Amidopyrine
Phenylbutazone
Chloramphenicol


Shock
Traumatic
Anaphylactic.
Irradiation
Exposure to X-ray and radioactive substances


LYMPHOCYTOSIS
Relative lymphocytosis occurs in conditions showing
polymorphonuclear leucopenia. Absolute lympho-
cytosis occurs in:
Pertussis
Infectious mononucleosis
Chronic lymphatic leukaemia
Chronic infections–tuberculosis, syphilis, infective
hepatitis
Mumps, measles, chickenpox
Thyrotoxicosis.


LYMPHOPENIA:
Administration of ACTH
In conditions of stress and carcinomatosis
Excessive radiation.


MONOCYTOSIS:
Bacterial infections
Tuberculosis, typhoid, brucellosis
Subacute bacterial endocarditis.

Protozoal
Malaria, kala-azar, amoebiasis
Monocytic leukaemia
Hodgkin’s disease.


EOSINOPENIA:
Administration of ACTH, adrenaline and ephedrine
Response to stress: Traumatic shock, surgical opera-
tions, burns, acute emotional stress, exposure to cold.
Endocrine disorders: Cushing’s disease and
acromegaly.
Aplastic anaemia, SLE


BASOPHILIA:
Chronic myeloid leukaemia
Polycythemia vera
Cirrhosis of liver
Early stages of Hodgkin’s disease
Lead poisoning (punctuate basophilia).


PLASMA CELLS
These are normally not present in peripheral blood, but
may be found in:
Measles, chickenpox (plasmacytoid lymphocytes)
Multiple myeloma with spillover
Plasma cell leukaemia