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leukocyte/ white blood cells
5 types
1) basophils
2) eosinophils
3) neutrophils
4) monocytes
5) lymphocytes
WBC- total white blood cell count
how many is normal
why is it useful?
differential white cell count (aka "diff")
4,500-10,00
bands 3-5%
useful as both a diagnostic tool and in following the course of disease
if needed, order a differential separately
diff: proportions of different types of leukocytes in the smear of the patient's venous blood
two basic groups of leukocytes
- grandulocytes
neutrophils (or segs) 50-70% relative value (2500-7000 absolute value)
eosinophils 1-3%
basophils: 0.4- 1%
- agranulocytes
lymphocytes 25-35% relative value (1700-3500)
monocytes 4-6% relative value (200-600)
granulocytes/PMNs
neutrophils
the body's primary defense against bacterial infection and physiologic stress
- comprised majority of WBC (60%)
- bands (immature neutrophils) 3-5% of WBC
increased with infections, granuocytic leukemia, burns
decreased with drugs, viral infections, bone marrow invasion or aplasia
eosinophils
attack parasites and act as phagocytes
antigen- antibody complexes
increased during an allergic reactions- hay fever, asthma, drug hypersensitivity, parasitic infection, pernicious anemia
decreased with infections, exogenous cortisone
basophil
not well understood but similar to mast cells
- secrete anti- coagulant and vasodilatory substances as histamines, heparin, and serotonin
- main function is secreting substance which mediate the hypersensitivity reaction
- possible phagocytory capability
increased with CML, polycythemia, myeloid metaplasia
non-granulocytes
the main constituents of the immune system
- defense against pathogenic micro organisms such as viruses,bacteria, fungi
- T cell matures in thymus gland
- B cell matures in bone marrow
- second most common WBC in adults (neutrophil #1)
- increased during infections, TB, lympocytic leukemia
monocytes
phagocytes and precursors of macrophages
- largest blood cells
- in presence of an inflammation site, monocytes quickly migrate from the blood vessel and start an intense phagocytory activity
increased during monocytic leukemia, TB, collagen disease,chronic infection or inflammation
bands/immature neutrophils
in general, a high number of immature cells in the peripheral blood reflects
- "push on the marrow" to produce cells in large quantities (ie common manifestation of bacterial infection is a shift to the left with high # of immature granulocytes or bands seen on differential)
- developmental arrest suggestign primary hematologic disease
neutropenia
definition
formula
absolute decrease in the number of circulating neutrophils in the blood
absolute neutrophil count (ANC)
ANC = (WBC x (% neutrophils + % bands))/ 100
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