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White blood cells

  1. 1. Dr Pallavi Saxena
  2. 2. Objectives Introduction Leucopoiesis Classification Morphology Properties Functions Applied physiology Recent advances
  3. 3. 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
  4. 4. Leucopoiesis Definition The process of development and maturation of white blood cells(leucocytes), is called leucopoiesis.
  5. 5. HEAMOCYTOBLAST MYELOID SERIES MYELOID STEM CELL MYELOBLAST PROMYELOCYTE GRANULOPOIESIS MYELOCYTE METAMYELOCYTE BAND FORM GRANULOCYTE
  6. 6. HEAMOCYTOBLAST MYELOID STEM CELL MYELOMONOBLAST FORMATION OF MONOCYTES PROMONOCYTE MONOCYTE (BLOOD) MACROPHAGE (TISSUES) MONOCYTE-MACROPHAGE SERIES
  7. 7. HEAMOCYTOBLAST LYMPHOID STEM CELL LYMPHOBLAST LYMPHOPOIESIS PROLYMPHOCYTE LYMPHOCYTE PLASMA CELLS
  8. 8. Regulation of leucopoiesis Granulopenia or dead granulocytes & monocytes Releases G-CSF M-CSF GM-CSF Interleukins Stimulate Bone Marrow Increased formation Granulocytes Monocytes/macrophages Normal counts inhibit
  9. 9. Normal range of WBC At birth,in full term infant: 10,000-25,000/μl of blood Infants upto 1 yr of age:6000-16,000/μl of blood Adults:4000-11,000/μl of blood
  10. 10. Variations in WBC count TLC > 11,000/μL(Leucocytosis) Physiological 1.Age 2.Exercise 3.Mental stress 4.Pregnancy 5.After food intake 6.Exp.to low temp. Pathological 1.Acute bacterial infections (pyogenic org.) 2.Burns 3.Post-operative period 4.Tuberculosis 5.Glandular fever
  11. 11. TLC < 4000/μL( Leucopenia) 1.Infections by non-pyogenic organisms e.g. typhoid fever 2.Viral infections, influenza,smallpox,mumps etc 3.Protozoal infections 4.Starvation & malnutrition 5.Aplasia of bone marrow 6.Bone marrow depression
  12. 12. Classification Granulocytes Agranulocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes
  13. 13. Neutrophils 1. Cell size- 10-14μm 2. Nucleus- central or eccentric; 2-6 lobes;deep purplish blue 3. Cytoplasm- faint pink 4. Granules- fine(pin-point); violet- Normal values pink in color •Differential:40 -75% •Absolute:2000 -7500/μl of blood
  14. 14. Eosinophils 1. Cell size- 10-14μm 2. 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
  15. 15. Basophils 1. Cell size- 10-14μm 2. 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
  16. 16. Monocyte 1. Cell size- 12-20μm 2. 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
  17. 17. 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:2 0-40% •Absolute: 1500-4000/μl of blood
  18. 18. Variation in counts Neutrophilia Absolute count > 10,000/μl of blood •Physiological & •Pathlogical causes Neutropenia Absolute count< 2500/μl of blood •Causes??
  19. 19. Life Span Of WBC Not constant.  Neutrophils -> 2-5 days  Eosinophils -> 7-12 days  Basophils -> 12-15 days  Monocytes -> 2-5 days  Lymphocytes -> ½-1 day
  20. 20. Properties Of WBC’s  Diapedesis  Ameboid movement  Chemotaxis  Phagocytosis
  21. 21. Properties of WBCs
  22. 22. FUNCTIONS
  23. 23. Neutrophils  1st line of defense  Granules contain enzymes like Nucleotidases Catalases  Antibody like substances -> Defensins
  24. 24. Eosinophils  Defense (specially against parasites )  Role in allergic reactions  Substances present in granules 1. Major basic protein 2. Eosinophilic cationic proteins 3. Eosinophil peroxidase 4. Aryl sulphatase B
  25. 25. Basophils  Role in allergic responses  Substances present in granules 1. Histamine 2. Heparin 3. Hyaluronic acid 4. Proteases & Myeloperoxidase
  26. 26. Monocytes  1st line of defense  Motile & phagocytic  Precursors of tissue macrophages secrete: 1. Interleukin 1 2. Colony stimulating factor 3. Platelet activating factor
  27. 27. Lymphocytes Immunity 1.T- Lymphocyte -> Cellular Immunity 2.B- Lymphocyte -> Humoral Immunity
  28. 28. APPLIED PHYSIOLOGY
  29. 29. Variation in counts Neutrophilia Absolute count > 10,000/μl of blood •Physiological & •Pathlogical causes Neutropenia Absolute count< 2500/μl of blood •Causes??
  30. 30. Variation in counts Eosinophilia •Absolute count > 500/μl of blood •Causes?? Eosinopenia •Absolute count < 50/μl of blood •Causes..??
  31. 31. Cont…. Basophilia •Absolute count >100/μl of blood •Causes Basopenia •Decrease in basophil count •Causes
  32. 32. Lymphocytosis •Absolute count> 4000/μl of blood •Physiological •Pathological causes Lymphopenia •Absolute count < 1500/μl of blood •Causes??
  33. 33. Monocytosis •Count > 800/μl of blood •Causes?? Monocytopenia •Decrease in monocyte count •Rare
  34. 34. PATHOLOGICAL VARIATIONS
  35. 35. CYCLIC NEUTROPENIA  Episodes of severe neutropenia usually lasting for 3-6 days Can be familial & inherited with maturation arrest
  36. 36. Hypereosinophilic syndrome Criteria of diagnosis Peripheral blood eosinophil >1.5 x 109/L Persistence of counts more than 6 months Organs involved Heart Lung Skin Neurological
  37. 37. LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) Congenital Pelger-Huet anomaly Bilobed and occasional unsegmented neutrophils Autosomal recessive disorder
  38. 38. Chediak-Higashi syndrome Autosomal recessive disorder Giant granules in granulocytes, monocytes and lymphocytes Recurrent pyogenic infections Lymphoproliferative syndrome may develop Treatment is BMT
  39. 39. Leukemia  WBC upto 1,000,00/cu.mm  It can be – 1. Acute – Lmphoblastic Myeloblastic 2. Chronic – Lymphatic Myeloid
  40. 40. RECENT ADVANCES
  41. 41. 1.Bone marrow transplantation 2.Apheresis & leucocyteapheresis 3.Use of special filters & leucocyte depleted blood 4.Flow cytometry 5.Alpha interferon
  42. 42. Bibliography Essentials of medical physiology by K.Sembulingam & Prema Sembulingam Medical physiology by Guyton & Hall Medical physiology by Indu Khurana Google search
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