Ch. 17 Leukocytes: Non-malignant lymph Disorders

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Ch. 17 Leukocytes: Non-malignant lymph Disorders
2013-02-10 13:51:49

Non-malignant lymph disorders
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  1. Lymphocytosis and Lymphocytopenia:
    Normal Adults
  2. Lymphocytopenia
    decreased lymphs
  3. Lymphocytosis:
    Increased lymphs
  4. Causes of lymphocytosis:
    • Acute viral infections
    • Some bacterial infections
    • Some parasitic infections
    • Drug reactions
  5. Causes of lymphocytopenia:
    • HIV
    • Genetic immune deficiencies
  6. Infectious Mononucleosis (IM):
    • Epstein-Barr Virus
    • DNA virus
    • Common Worldwide
    • Transmitted via oro-pharyngeal secreations
    • 10-50 day incubation
    • 95% of adults have been exposed to EBV
    • Seronegative at birth-->Seropositive adults

    • Asymptomatic to poorly defined symptoms
    • Normally benign, but serious for immunocompromised.
  7. IM symptoms:
    • Fatigue, sore throat, fever, lymphadenopathy
    • Deaths have occurred from ruptured spleen
  8. Lab findings in IM:
    • Leukocytosis (90%)
    • 60-90% lymphocytes in peripheral smear
    • 5-30% ALTs

    • Heterophile Test: EBV antibodies crossreact with antigens of other species (horse RBC)
    • Not all IM infections have positive heterophile tests
    • More specific serological tests are available.
    • EBV infected B-lymphs acquire new antigens and their corresponding antigens.
    • Variant Lymphocytes
    • RBC indentation of the lymphocyte cytoplasm with blue ridge
    • Large irregular nuclei and large amounts of irregular cytoplasm
    • Nuclear chromatin may appear immature with possible nucleoli.
  9. Cytomegalovirus (CMV)
    • Worldwide distribution
    • Herpes virus family-DNA Virus
    • Transmitted thru oral, respiratory, sexually, transfusions, organs
  10. Symptoms of CMV:
    • Asymptomatic for immune competent
    • Fever, chills, sore throat, malaise
    • Significant cause of death for HIV and premature infants
  11. Lab of CMV:
    • Leukocytosis with Variant Lymphs
    • Elevated liver enzyme tests
    • Positive serological tests
  12. Toxoplasmosis:
    • Infection by the intracellular parasite Toxoplasma gondii
    • T. gondii infects many different animals (common in domestic cats)
    • Has 3 stages: Oocyts/Trophozoites/Tissue cysts
    • Human infection occurs from cat boxes, undercooked or raw meet
    • Infections can be serious for immunocompromised (HIV, Newborns)
    • Lymphocystis with Variant lymphs
    • Diagnosed by serological techniques
  13. Infectious Lymphocytes:
    • Coxsackle virus (probably)
    • usually seen in children
    • Associated with isolated outbreaks
    • Self-limiting
  14. Symptoms of Infectious Lymphocytes:
    • Vomiting, diarrhea, fever, rashes, respiratory symptoms, swollen nodes
    • Leukocytosis (up to 95% small,mature lymphs)
  15. Bordetella pertussis
    • Bacterial infection from Bordetella pertussis (whooping cough)
    • Acquired from airborne droplets (coughing, sneezing)
    • Very infectious
    • Uncommon because of DPT vaccine, but cases are increasing

    • Painful, severe to fatal respiratory infections
    • Leukocytosis and lymphocytosis

    • Small lymphocytes with clef-nucleus
    • Definition diagnosis from bacterial culture.
  16. (AIDS) Acquired Immunodeficiency Syndrome
    • Infection of HIV-1 virus
    • HIV-2 also causes AIDs but rare

    HIV infects Helper/Inducer T-lymphs (CD4)

    • Opportunistic infections (CMV, EBV, TB, Pneumocystis, Kaposi's)
    • Acquired from body fluids
  17. Lab of AIDs:
    • Leukopenia and lymphocytopenia
    • T-lymph deficiency
    • Helper/Suppressor Ratio < 2.0
    • Diagnosis by serological tests
  18. SLE) Systemic Lupus Erythematosus
    • Systemic autoimmune disease
    • Increased Helper T-lymph and B-Lymph activity against connective and renal tissues

    Diagnosed: ANA serological tests