Leukocyte (WBC) parameters

Neutrophils

Neutrophilic leukocytosis (neutrophilia) may be the result of:

1. intense production of cells in bone marrow
2. increased migration of neutrophils from the bone marrow into the blood
3. redistribution of neutrophils from marginal to circulating pool
4. delay migration of neutrophils from blood into tissue
5. the combined action of the above reasons

The causes of neutrophilic leukocytosis:

Reactive leukocytosis	Neoplastic leukocytosis
- infection (bacterial, fungal, parasitic) - malignant neoplasms - hemolytic anemia - acute hemorrhage - drugs - inflammatory and necrotic processes - acidosis, eclampsia, uremia, gout - lymphogranulomatosis - physical and emotional stress - pregnancy	- myeloproliferative diseases

Leukopenia with neutropenia (less than 2.0*10⁹/L) — can be functional and organic.

Agranulocytosis is a sharp decrease in the number of granulocytes in the peripheral blood up to their disappearance. The criterion for the diagnosis of agranulocytosis is the decrease of white blood cells less than 1*10⁹/L, granulocytes — less than 0.75*10⁹/L.

Causes of neutropenia:

Functional neutropenia	Organic neutropenia
- infection (bacterial, fungal, viral, caused by a protozoan, rickettsia) - malnutrition, starvation - drugs (increased immune destruction of cells) - anaphylactic shock - autoimmune diseases (systemic lupus erythematosus, chronic lymphocytic leukemia, rheumatoid arthritis) - liver disease - splenomegaly (portal hypertension, lymphoma, tuberculosis)	- acute leukemias - lymphoproliferative disorders - myelodysplastic syndrome - megaloblastic anemia - hereditary benign neutropenia, cyclic neutropenia, Chediak-Higashi syndrome (CHS) - radiation sickness - agranulocytosis - aplastic anemia

 

Eosinophils

In most cases, eosinophilia reflects allergic reactions and is observed in the phase of convalescence in infectious diseases.

Causes of eosinophilia:

Reactive eosinophilia

Neoplastic eosinophilia

- parasitic infection (ascariasis, toxocariasis, trichinosis, echinococcosis, shistosomiasis, filariasis, strongyloidiasis, opisthorchiasis, hookworm disease, giardiasis) - allergic diseases (drug allergy, bronchial asthma, allergic dermatitis) - autoimmune diseases, connective tissue disease - drugs - granulomatous processes - lymphogranulomatosis - malignant tumors, especially with metastases and necrosis - immunodeficiencies (Wiskott-Aldrich syndrome, WAS)

- acute leukemia with eosinophilia (M4Eo) - chronic myeloid leukemia - erythremia

Eosinopenia — a decrease in the number of eosinophils in the blood is less than 0.2*10⁹/L or aneozinofiliya (the absence of eosinophils in the blood) occurs in the first stage of the inflammatory process, if severe purulent infections, shock, stress, eclampsia and intrapartum, intoxication by various chemical compounds and heavy metals.

 

Basophils

Basophilia observed in the majority of myeloproliferative diseases (chronic myeloleukemia, myelofibrosis, erythremia), ulcerative colitis, hypersensitivity reactions (food, drug, inhaled allergens), nephrosis, lymphogranulomatosis, in the early phase of rheumatism.

Basopenia (or basocytopenia) is difficult to assess because of the small content of normal basophils in the blood.

 

Monocytes

Causes of monocytosis:

Reactive monocytosis	Neoplastic monocytosis
- infections (viral, parasitic, bacterial, protozoal) - inflammatory diseases - autoimmune diseases (SLE, rheumatoid arthritis, polyarteritis nodosa) - granulomatous processes (tuberculosis, syphilis, brucellosis, sarcoidosis, ulcerative colitis, enteritis) - malignant neoplasms (cancer, sarcoma, multiple myeloma)	- acute monoblastic and myelomonoblastic leukemia - chronic monocytic and myelomonocytic leukemia

Monotsitopeniya — occurs in the hematopoiesis hypoplasia (bone marrow hypoplasia and aplasia, acute leukemias, hairy cell leukemia, acute infection, use of certain medications).

 

Lymphocytes

Causes of lymphocytosis:

Reactive (polyclonal) lymphocytosis	Neoplastic (monoclonal) lymphocytosis
- viral and parasitic infections - granulomatous processes (tuberculosis, syphilis, brucellosis) - autoimmune diseases - malignant disease	- acute and chronic lymphocytic leukemia - leukemic phase of lymphoma - heavy chain disease (HCDs)

Lymphocytopenia - lymphocyte counts less than 1.0*10⁹/L cells. Lymphocytopenia observed in:

• acute infectious diseases
• miliary tuberculosis
• systemic lupus erythematosus
• renal failure
• lymphogranulematosis
• in the terminal stage of malignant neoplasms
• acute radiation sickness
• in the terminal stage of AIDS
• in secondary immunodeficiencies

 

Plasma cells

Plasma cells normally do not find in the blood. Plasma cells appear in:

• some viral diseases (measles, rubella, chickenpox, infectious mononucleosis, infectious hepatitis)
• long-term persistence of antigen (serum sickness, chronic sepsis, tuberculosis, actinomycosis, collagen diseases, autoimmune diseases, tumors)
• terminal stage of multiple myeloma
• in acute plasmablasts leukemia

 

Atypical mononuclear cells

Atypical mononuclear cells are blast-transformed lymphocytes appearing in the blood caused by extensive of cellular immunity. Normally, the number of atypical mononuclear cells does not exceed 6% of all leukocytes (the ratio of the number of wide-cytoplasmic lymphocytes to narrow-cytoplasmic 0,15).

The number of atypical mononuclear cells in the blood increases in:

• viral diseases (infectious mononucleosis, measles, rubella, chickenpox, influenza, viral hepatitis, adenovirus disease, cytomegalovirus infection)
• allergic reactions
• vaccinations
• autoimmune diseases
• tumors
• transplant rejection reactions