White blood cell pathology

White blood cell parameters

 * leukocytosis: > 10,000,
 * leukopenia: < 4,000
 * neutropenia: < 1,000 (in children 2 weeks to 1 year), < 1,500 (in children over 1 year),
 * agranulocytosis: < 500,
 * lymphocytosis: > 5,000,
 * lymphopenia: < 1,500,
 * monocytosis: > 800 or > 10 % in diff.,
 * eosinophilia: > 600 or > 10 % in diff.,
 * basophilia: > 100 or > 1 % in diff.



Differential diagnosis of leukocytosis and neutrophilia

 * Pyogenic infections,
 * connective tissue disease,
 * glomerulonephritis,
 * acidosis,
 * uremia,
 * acute bleeding,
 * hemolysis,
 * burns,
 * surgery,
 * liver necrosis,
 * dehydration,
 * corticoids,
 * catecholamines,
 * poisoning lead and  mercury,
 * metastases in bone marrow.

Physiological causes of leukocytosis and neutrophilia

 * Stress,
 * physical exertion,
 * intense crying in newborn,
 * smoking.

Leukemoid reactions
The leukemoid reaction is a situation where we find tens of thousands of leu/mm3+a significant shift to immature forms. The determination of ALP in neutrophils can help in differential diagnosis (in leukemia ALP is decreased, in leukemoid response in infection or systemic disease ALP is normal or increased). When in doubt, it provides security bone marrow aspiration.

Differential diagnosis of lymphocytosis
Absolute lymphocytosis
 * infectious lymphocytosis,
 * infectious mononucleosis,
 * pertussis,
 * lues,
 * TBC,
 * hyperthyroidism.

relative lymphocytosis
 * morbilli,
 * exanthema subitum.

Differential diagnosis of neutropenia

 * congenital
 * reticular dysgenesis,
 * congenital pluripotent stem cell disorder
 * m. Kostmann,
 * cyclic neutropenia,
 * Schwachmann sy.,
 * neutropenia in DMP: glycogenosis, Gaucher.


 * gained
 * isoimmune neonatal neutropenia,
 * vitamin B12 deficiency,
 * folic acid deficiency,
 * autoimmune etiology,
 * SLE,
 * JIA,
 * SCID,
 * Hyper IgM syndrome,
 * Evans syndrome,
 * lymphomas,
 * drugs: chloramphenicol, antiepileptics, thyrostatics,
 * infections: EBV, CMV, HHV 6, HIV, Parvovirus, hepatitis, varicella, parotitis,
 * idiopathic neutropenia.

Differential diagnosis of eosinophilia

 * Allergic diseases,
 * skin diseases: eczema atopicum,
 * parasitic infections: toxocarosis, oxyuriasis,
 * m.Hodgkin,
 * scarlatina.

Source

 * HAVRÁNEK, Jiří:  Hematologie - obecný úvod . (managed)

Related Articles

 * Physiological and pathophysiological notes on pediatric hematology (pediatrics) • Neutropenia in children
 * Diseases of the white blood component:
 * Leukemia: Acute myeloid leukemia • Acute lymphocytic leukemia • Chronic myeloid leukemia • Chronic lymphocytic leukemia
 * Malignant lymphoma: Hodgkin's lymphoma • Non-Hodgkin's lymphoma
 * Histiocytosis
 * Diseases of the red blood component: Anemia • Polyglobulia