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White Blood Cell

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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