1. Dr Pallavi Saxena

2. ObjectivesIntroductionLeucopoiesisClassificationMorphologyPropertiesFunctionsApplied physiologyRecent advances 3. Introduction Why leucocytes called white cells??Gabriel Andral,a French professor of medicine andWilliam Addison, an English countrypractitioner,reported simultaneously the firstdescription of leucocytes (1843)Play important role in immunity of the body 4. LeucopoiesisDefinitionThe process of development and maturation ofwhite blood cells(leucocytes), is calledleucopoiesis. 5. HEAMOCYTOBLASTMYELOID SERIESMYELOID STEMCELLMYELOBLASTPROMYELOCYTEGRANULOPOIESISMYELOCYTEMETAMYELOCYTEBAND FORMGRANULOCYTE 6. HEAMOCYTOBLASTMYELOID STEM CELLMYELOMONOBLASTFORMATION OFMONOCYTESPROMONOCYTEMONOCYTE(BLOOD)MACROPHAGE(TISSUES)MONOCYTE-MACROPHAGESERIES 7. HEAMOCYTOBLASTLYMPHOID STEM CELLLYMPHOBLASTLYMPHOPOIESISPROLYMPHOCYTELYMPHOCYTEPLASMA CELLS 8. Regulation of leucopoiesisGranulopenia or dead granulocytes & monocytesReleasesG-CSFM-CSFGM-CSFInterleukinsStimulateBone MarrowIncreased formationGranulocytesMonocytes/macrophagesNormalcounts inhibit 9. Normal range of WBCAt birth,in full term infant: 10,000-25,000/lof bloodInfants upto 1 yr of age:6000-16,000/l ofbloodAdults:4000-11,000/l of blood 10. Variations in WBC countTLC > 11,000/L(Leucocytosis)Physiological1.Age2.Exercise3.Mental stress4.Pregnancy5.After food intake6.Exp.to low temp.Pathological1.Acute bacterialinfections(pyogenic org.)2.Burns3.Post-operativeperiod4.Tuberculosis5.Glandular fever 11. TLC < 4000/L( Leucopenia)1.Infections by non-pyogenic organisms e.g.typhoid fever2.Viral infections, influenza,smallpox,mumpsetc3.Protozoal infections4.Starvation & malnutrition5.Aplasia of bone marrow6.Bone marrow depression 12. ClassificationGranulocytes AgranulocytesNeutrophilsEosinophilsBasophilsLymphocytesMonocytes 13. Neutrophils1. Cell size- 10-14m2. Nucleus- central or eccentric; 2-6lobes;deep purplish blue3. Cytoplasm- faint pink4. Granules- fine(pin-point); violet-Normal values pink in colorDifferential:40-75%Absolute:2000-7500/l ofblood 14. Eosinophils1. Cell size- 10-14m2. Nucleus- central or eccentric; 2-3lobes; purplish blue; spectacleshaped3. Cytoplasm- acidophilic;brightpink in color4. Granules- large; coarse; crimsonredNormal valuesDifferential: 1-6%Absolute:40-440/l of blood 15. Basophils1. Cell size- 10-14m2. Nucleus- central; 2-3 lobes;purplish blue; overlaid withgranules3. Cytoplasm- basophilic; full ofgranules4. Granules- very coarse,deeppurple or blueNormal valuesDifferential: 0-1%Absolute: 0-100/l of blood 16. Monocyte1. Cell size- 12-20m2. Nucleus- eccentric or central;round or oval; pale bluishviolet3. Cytoplasm- abundant; paleblue; clearNormal valuesDifferential:2-10%Absolute:500-800/l ofblood 17. Lymphocyte1. Cell size- LL:12-16m; SL:7-10m2. Nucleus- eccentric; largeround nucleus; deep purplishblue3. Cytoplasm- scanty; light bluecolorNormal valuesDifferential:20-40%Absolute:1500-4000/lof blood 18. Variation in countsNeutrophiliaAbsolute count >10,000/l of bloodPhysiological &Pathlogical causesNeutropeniaAbsolute count 2-5 days Eosinophils -> 7-12 days Basophils -> 12-15 days Monocytes -> 2-5 days Lymphocytes -> -1 day 20. Properties Of WBCs Diapedesis Ameboid movement Chemotaxis Phagocytosis 21. Properties of WBCs 22. FUNCTIONS 23. Neutrophils 1st line of defense Granules contain enzymes likeNucleotidasesCatalases Antibody like substances -> Defensins 24. Eosinophils Defense (specially against parasites ) Role in allergic reactions Substances present in granules1. Major basic protein2. Eosinophilic cationic proteins3. Eosinophil peroxidase4. Aryl sulphatase B 25. Basophils Role in allergic responses Substances present in granules1. Histamine2. Heparin3. Hyaluronic acid4. Proteases & Myeloperoxidase 26. Monocytes 1st line of defense Motile & phagocytic Precursors of tissue macrophagessecrete:1. Interleukin 12. Colony stimulating factor3. Platelet activating factor 27. LymphocytesImmunity1.T- Lymphocyte -> Cellular Immunity2.B- Lymphocyte -> Humoral Immunity 28. APPLIEDPHYSIOLOGY 29. Variation in countsNeutrophiliaAbsolute count >10,000/l of bloodPhysiological &Pathlogical causesNeutropeniaAbsolute count 500/l ofbloodCauses??EosinopeniaAbsolute count 100/lof bloodCausesBasopeniaDecrease inbasophil countCauses 32. LymphocytosisAbsolute count>4000/l of bloodPhysiologicalPathologicalcausesLymphopeniaAbsolutecount 800/lof bloodCauses??MonocytopeniaDecrease inmonocyte countRare 34. PATHOLOGICALVARIATIONS 35. CYCLIC NEUTROPENIA Episodes of severe neutropenia usuallylasting for 3-6 daysCan be familial & inherited with maturationarrest 36. Hypereosinophilic syndromeCriteria of diagnosisPeripheral blood eosinophil >1.5 x 109/LPersistence of counts more than 6 monthsOrgans involvedHeartLungSkinNeurological 37. LEUCOCYTES BENIGN DISORDERSQualitative changes (MORPHOLOGY)CongenitalPelger-Huet anomalyBilobed and occasional unsegmentedneutrophilsAutosomal recessive disorder 38. Chediak-Higashi syndromeAutosomal recessive disorderGiant granules in granulocytes, monocytes andlymphocytesRecurrent pyogenic infectionsLymphoproliferative syndrome may developTreatment is BMT 39. Leukemia WBC upto 1,000,00/cu.mm It can be 1. Acute LmphoblasticMyeloblastic2. Chronic LymphaticMyeloid 40. RECENTADVANCES 41. 1.Bone marrow transplantation2.Apheresis & leucocyteapheresis3.Use of special filters & leucocyte depletedblood4.Flow cytometry5.Alpha interferon 42. BibliographyEssentials of medical physiology byK.Sembulingam & Prema SembulingamMedical physiology by Guyton & HallMedical physiology by Indu KhuranaGoogle search