white blood cells
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Dr Pallavi Saxena
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ObjectivesIntroductionLeucopoiesisClassificationMorphologyPropertiesFunctionsApplied physiologyRecent advances
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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
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Leucopoiesis
DefinitionThe process of development and maturation of white blood cells(leucocytes), is called leucopoiesis.
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MYELOID SERIES
HEAMOCYTOBLAST
MYELOID STEM CELL
MYELOBLAST
PROMYELOCYTE
MYELOCYTE
METAMYELOCYTE
BAND FORM
GRANULOCYTE
GRANULOPOIESIS
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HEAMOCYTOBLAST
MYELOID STEM CELL
MYELOMONOBLAST
PROMONOCYTE
MONOCYTE (BLOOD)
MACROPHAGE (TISSUES)
FORMATION OF MONOCYTES
MONOCYTE-MACROPHAGE SERIES
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HEAMOCYTOBLAST
LYMPHOID STEM CELL
LYMPHOBLAST
PROLYMPHOCYTE
LYMPHOCYTE
PLASMA CELLS
LYMPHOPOIESIS
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Regulation of leucopoiesis
Granulopenia or dead granulocytes & monocytes
G-CSFM-CSFGM-CSFInterleukins
Releases
Bone Marrow
GranulocytesMonocytes/macrophages
Stimulate
Increased formationNormal counts inhibit
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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
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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
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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
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Classification
Granulocytes Agranulocytes
Neutrophils
Eosinophils
Basophils
LymphocytesMonocytes
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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
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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
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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
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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
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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
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Variation in counts
NeutrophiliaAbsolute count > 10,000/µl of blood•Physiological &
•Pathlogical causes
NeutropeniaAbsolute count< 2500/µl of blood
•Causes??
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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
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Properties Of WBC’s Diapedesis Ameboid movement Chemotaxis Phagocytosis
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Properties of WBCs
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FUNCTIONS
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Neutrophils
1st line of defense
Granules contain enzymes like Nucleotidases Catalases Antibody like substances -> Defensins
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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
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Basophils Role in allergic responses Substances present in granules 1. Histamine2. Heparin3. Hyaluronic acid4. Proteases & Myeloperoxidase
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Monocytes
1st line of defense Motile & phagocytic Precursors of tissue macrophages
secrete:1. Interleukin 12. Colony stimulating factor3. Platelet activating factor
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Lymphocytes
Immunity1.T- Lymphocyte -> Cellular Immunity
2.B- Lymphocyte -> Humoral Immunity
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APPLIED PHYSIOLOGY
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Variation in counts
NeutrophiliaAbsolute count > 10,000/µl of blood•Physiological &
•Pathlogical causes
NeutropeniaAbsolute count< 2500/µl of blood
•Causes??
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Variation in counts
Eosinophilia•Absolute count > 500/µl of blood•Causes??
Eosinopenia•Absolute count < 50/µl of blood
•Causes..??
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Basophilia•Absolute count >100/µl of blood
•Causes
Cont….
Basopenia•Decrease in basophil count
•Causes
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Lymphocytosis•Absolute count> 4000/µl of blood
•Physiological•Pathological causes
Lymphopenia•Absolute count < 1500/µl of blood
•Causes??
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Monocytosis•Count > 800/µl of blood
•Causes??
Monocytopenia•Decrease in monocyte count
•Rare
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PATHOLOGICAL VARIATIONS
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CYCLIC NEUTROPENIA
Episodes of severe neutropenia usually lasting for 3-6 days
Can be familial & inherited with maturation arrest
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Hypereosinophilic syndrome
Criteria of diagnosisPeripheral blood eosinophil >1.5 x 109/LPersistence of counts more than 6 months
Organs involvedHeartLungSkinNeurological
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LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY)
CongenitalPelger-Huet anomaly
Bilobed and occasional unsegmented neutrophils
Autosomal recessive disorder
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Chediak-Higashi syndromeAutosomal recessive disorderGiant granules in granulocytes, monocytes and
lymphocytesRecurrent pyogenic infectionsLymphoproliferative syndrome may developTreatment is BMT
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Leukemia WBC upto 1,000,00/cu.mm It can be –1. Acute – Lmphoblastic Myeloblastic2. Chronic – Lymphatic Myeloid
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RECENT ADVANCES
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1.Bone marrow transplantation2.Apheresis & leucocyteapheresis3.Use of special filters & leucocyte depleted
blood4.Flow cytometry5.Alpha interferon
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BibliographyEssentials of medical physiology by
K.Sembulingam & Prema Sembulingam
Medical physiology by Guyton & Hall
Medical physiology by Indu Khurana
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