white blood cells
DESCRIPTION
TRANSCRIPT
Dr Pallavi Saxena
ObjectivesIntroductionLeucopoiesisClassificationMorphologyPropertiesFunctionsApplied physiologyRecent advances
Introduction Why leucocytes called white cells??
Gabriel Andral,a French professor of medicine and William Addison, an English country practitioner,reported simultaneously the first description of leucocytes (1843)
Play important role in immunity of the body
Leucopoiesis
DefinitionThe process of development and maturation of white blood cells(leucocytes), is called leucopoiesis.
MYELOID SERIES
HEAMOCYTOBLAST
MYELOID STEM CELL
MYELOBLAST
PROMYELOCYTE
MYELOCYTE
METAMYELOCYTE
BAND FORM
GRANULOCYTE
GRANULOPOIESIS
HEAMOCYTOBLAST
MYELOID STEM CELL
MYELOMONOBLAST
PROMONOCYTE
MONOCYTE (BLOOD)
MACROPHAGE (TISSUES)
FORMATION OF MONOCYTES
MONOCYTE-MACROPHAGE SERIES
HEAMOCYTOBLAST
LYMPHOID STEM CELL
LYMPHOBLAST
PROLYMPHOCYTE
LYMPHOCYTE
PLASMA CELLS
LYMPHOPOIESIS
Regulation of leucopoiesis
Granulopenia or dead granulocytes & monocytes
G-CSFM-CSFGM-CSFInterleukins
Releases
Bone Marrow
GranulocytesMonocytes/macrophages
Stimulate
Increased formationNormal counts inhibit
Normal range of WBC
At birth,in full term infant: 10,000-25,000/µl of bloodInfants upto 1 yr of age:6000-16,000/µl of bloodAdults:4000-11,000/µl of blood
Variations in WBC countTLC > 11,000/µL(Leucocytosis)
Physiological1.Age2.Exercise3.Mental stress4.Pregnancy5.After food intake6.Exp.to low temp.
Pathological1.Acute bacterial infections (pyogenic org.)2.Burns3.Post-operative period4.Tuberculosis5.Glandular fever
TLC < 4000/µL( Leucopenia)1.Infections by non-pyogenic organisms e.g. typhoid fever2.Viral infections, influenza,smallpox,mumps etc3.Protozoal infections4.Starvation & malnutrition5.Aplasia of bone marrow6.Bone marrow depression
Classification
Granulocytes Agranulocytes
Neutrophils
Eosinophils
Basophils
LymphocytesMonocytes
Neutrophils
1. Cell size- 10-14µm2. Nucleus- central or eccentric; 2-6
lobes;deep purplish blue3. Cytoplasm- faint pink4. Granules- fine(pin-point); violet-
pink in color Normal values•Differential:40-75%•Absolute:2000-7500/µl of blood
Eosinophils1. Cell size- 10-14µm2. Nucleus- central or eccentric; 2-3
lobes; purplish blue; “spectacle shaped”
3. Cytoplasm- acidophilic;bright pink in color
4. Granules- large; coarse; crimson red
Normal values•Differential: 1-6%•Absolute:40-440/µl of blood
Basophils1. Cell size- 10-14µm2. Nucleus- central; 2-3 lobes;
purplish blue; overlaid with granules
3. Cytoplasm- basophilic; full of granules
4. Granules- very coarse,deep purple or blue
Normal values•Differential: 0-1%•Absolute: 0-100/µl of blood
Monocyte1. Cell size- 12-20µm2. Nucleus- eccentric or central;
round or oval; pale bluish violet
3. Cytoplasm- abundant; pale blue; clear
Normal values•Differential: 2-10%•Absolute:500-800/µl of blood
Lymphocyte
1. Cell size- LL:12-16µm; SL:7-10µm
2. Nucleus- eccentric; large round nucleus; deep purplish blue
3. Cytoplasm- scanty; light blue color
Normal values•Differential:20-40%•Absolute: 1500-4000/µl of blood
Variation in counts
NeutrophiliaAbsolute count > 10,000/µl of blood•Physiological &
•Pathlogical causes
NeutropeniaAbsolute count< 2500/µl of blood
•Causes??
Life Span Of WBCNot constant. Neutrophils -> 2-5 days Eosinophils -> 7-12 days Basophils -> 12-15 days Monocytes -> 2-5 days Lymphocytes -> ½-1 day
Properties Of WBC’s Diapedesis Ameboid movement Chemotaxis Phagocytosis
Properties of WBCs
FUNCTIONS
Neutrophils
1st line of defense
Granules contain enzymes like Nucleotidases Catalases Antibody like substances -> Defensins
Eosinophils
Defense (specially against parasites )
Role in allergic reactions
Substances present in granules 1. Major basic protein2. Eosinophilic cationic proteins3. Eosinophil peroxidase4. Aryl sulphatase B
Basophils Role in allergic responses Substances present in granules 1. Histamine2. Heparin3. Hyaluronic acid4. Proteases & Myeloperoxidase
Monocytes
1st line of defense Motile & phagocytic Precursors of tissue macrophages
secrete:1. Interleukin 12. Colony stimulating factor3. Platelet activating factor
Lymphocytes
Immunity1.T- Lymphocyte -> Cellular Immunity
2.B- Lymphocyte -> Humoral Immunity
APPLIED PHYSIOLOGY
Variation in counts
NeutrophiliaAbsolute count > 10,000/µl of blood•Physiological &
•Pathlogical causes
NeutropeniaAbsolute count< 2500/µl of blood
•Causes??
Variation in counts
Eosinophilia•Absolute count > 500/µl of blood•Causes??
Eosinopenia•Absolute count < 50/µl of blood
•Causes..??
Basophilia•Absolute count >100/µl of blood
•Causes
Cont….
Basopenia•Decrease in basophil count
•Causes
Lymphocytosis•Absolute count> 4000/µl of blood
•Physiological•Pathological causes
Lymphopenia•Absolute count < 1500/µl of blood
•Causes??
Monocytosis•Count > 800/µl of blood
•Causes??
Monocytopenia•Decrease in monocyte count
•Rare
PATHOLOGICAL VARIATIONS
CYCLIC NEUTROPENIA
Episodes of severe neutropenia usually lasting for 3-6 days
Can be familial & inherited with maturation arrest
Hypereosinophilic syndrome
Criteria of diagnosisPeripheral blood eosinophil >1.5 x 109/LPersistence of counts more than 6 months
Organs involvedHeartLungSkinNeurological
LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY)
CongenitalPelger-Huet anomaly
Bilobed and occasional unsegmented neutrophils
Autosomal recessive disorder
Chediak-Higashi syndromeAutosomal recessive disorderGiant granules in granulocytes, monocytes and
lymphocytesRecurrent pyogenic infectionsLymphoproliferative syndrome may developTreatment is BMT
Leukemia WBC upto 1,000,00/cu.mm It can be –1. Acute – Lmphoblastic Myeloblastic2. Chronic – Lymphatic Myeloid
RECENT ADVANCES
1.Bone marrow transplantation2.Apheresis & leucocyteapheresis3.Use of special filters & leucocyte depleted
blood4.Flow cytometry5.Alpha interferon
BibliographyEssentials of medical physiology by
K.Sembulingam & Prema Sembulingam
Medical physiology by Guyton & Hall
Medical physiology by Indu Khurana
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