64. qualitative and quantitative d/o in leucocyte. leucocytic formula. its role in clinic. etio n patho of leukopenia.

leukone: morphofunctional unit of blood which include organs of leukopenia and leukodieresis, in, pool of mature wbc in blood and tissue n mechanism of regulation n interaction btwn them.. Quantitative: (change in no number: leukocytosis: >7500/microL leukopenis <2500/microL normal: 4000-10000 Qualitative change (non-malignant) i)cytoplasmic -toxic granulation (bact infection) -toxic vacoulization (bact inf) -abnormal bodies (dohle body=neutrophil) -increase in vol ii) nucleus change -hypersegmentation -variable shape -delicate chromatin -decreased nuclear lobe *qualitative change lead to functional disorder -mobility is impaired -cells fail to respond to inflammatory stimuli -abnormal granule release -inability to ingest microorganism -slow bacterial killing -failure of both cellular and humoral immunity -defective chemotaxis -defective phagocytosis leucocytic formula % of cells in 1 litre of blood leukocyte:100% neutrophil= 65-72% eosinophills= 4-6% basophil= 0-1% monocyte= 6-8% lymphocyte= 20-50% Total lymphocyte counts (TLC) adults = 4 000-11 000/microL infants (fullterm birth) =10 000-25 000 infants (1 year) = 6 000-16 000 children (4-7 y) =5 000- 15 000 children (8-12 y) = 4 500-13 500 clinical imp: -effectiveness of therapy -access etio and patho

-causes of dz maybe absolute or relative -stages of dz -prognosis to understand correct way to treat pt -understand treatment *no of wbc change can be increase= myeloproliferative, infection decrease= immunodefeciency dz

Leukopenia -reduction of wbc <4000/microL -increase sensitivity to infection mechanism -decrease/increase production of neutrophil -abnormalities in destruction of neutrophil (pseduneutropenia) -false neutropenia causes a) infectious agents -bacteria= typhoid, paratyphoid -virus= measles, rubella, influenza, hepatitis -protozoa= malaria, kala azar -overwhelming bacterial infection b)physical agent -radiation -temperature c)hemapoetic d/o -aplastic anemia -lymphoma -fibrosis of bone marrow d)hypersplenism -selective pooling of neutrophil in spleen or increase destruction e)drug induced netropenis -cytotoxic drug (replicated cell r primary target of drugs, irrepairable damage to bone marrow) -noncytotoxic drug (interfere cell metabolism, immunological destruction, impair DNA synthesis n marrow aplasia) according to pathogenic principle (4 types of neutropenia) a) due to reduced production of neutrophills in bone marrow -due to decreased proliferative activity of bone marrow -difficulties in maturation of blast cells b)due to slowdown of neutrophills from bone marrow into blood stream -asso with reduction in mobility of neutrophil (lazy leucocyte sundrome) -mobility violated by products of virulent micro-organism, viruses, drugs and by decreased of receptors on surface n reduction of glucose which is the main energy of neut c)due to reduction in circulation time of neutrophil in blood stream

-destruction of neutrophil occur due to damage by immune complex -disability : B12 n folic acid deficient anemia and chediak higashi dz *enhance production of promyelocytic n myelocytic cells d)neutropenia associated with redistribution of neutrophil within vascular channel -false neutropenia -benign -asymptomatic -decrease circulation pool of cell -often observed in athletes after massive inflammatory process (hyperemia)