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백혈구 구조 , 기능 및 백혈구질환

http://blog.naver.com/hyouncho2/60088163283

Back to Basic백혈구 종류

Granulocyte : neutrophil, eosinoiphil, basophil Monocyte *mactophage histiocyte = tissue macrophageLymphocyte *plasma cell

Back to BasicDifferentiation of Myeloid Cells

Pleuripotent stem cell (PST) → CFU-GEMM → CFU-GM → CFU-G →Myeloblast → promyelocyte → myelocyte → metamyelocyte → band neutophil → segmented neutrophil (eosinophil, basophil)

Back to BasicMyeloid Pools (compartments)

Bone marrow : Stem cell pool: PSC – CFU-G Mitotic pool (5 ds ): myeloblast-myelocyte Post mitotic (reserve) pool (6.6 ds): metamyelocyte - seg.N Peripheral blood (9.5 hrs) : Circulating pool Marginated pool Tissue

http://blog.naver.com/hyouncho2/60105729162

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• Primary granules: myeloperoxidase, lactoferrin, leukocyte adhesion receptors, ALP, defensin, azurophil-derived bactericidal factor (ADBF)

• Secondary granules: lysozyme, collagenase, plasmin activator

• Tertiary granules : adhesion molecules, gelatinase, C3b receptor

• Surface membrane: CD11/CD18 complex, receptors for opsonin, chemotaxin, GM-CSF, G-CSF, phospholipid(PGE2, leukotriene, etc)

• Cytoplasm: actin, myosin, tubulin

과립구 ( 중성구 ) 구조

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Adhesion Cascade

중성구 살균 기능 - 관여물질

Back to BasicPhagocytosis and Killing

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Defects of chemotaxis : aspirin, alcohol, corticosteroids, leukemias, lazy leucocyte syndrome

Defects of phagocytosis: lack of opsonization (hypogammaglobulinemia)

Defects of killing: chronic granulomatous disease (cytochrome b558 def), myeloperoxidase def.

Back to Basic백혈구 수 (/mL) 변화

Neutrophilia : >7,500 Neutropenia : <1,500 Severe neutropenia : <500 Agranulocytosis : <100

Eosinophilia : 직접계산 ; 350 이상 , 백혈구 백분율로 환산 ; 500 이상 Basophilia : 200 이상 Monocytosis : 1,000 이상 Lymphocytosis : 성인 4,000 이상 , 소아 8,800 이상

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InfectionToxins: metabolic (uremia), drugs, chemicalsTissue destruction or necrosis: trauma, burns, myositis, vaculitis, infarction, neoplasiaMetabolic disorder : uremia, eclampsiaHemorrhage, especially into a body cavityRapid hemolysisHematologic disorders: leukemias, myeloproliferative neoplasmPseudoneutrophilia : physical stress, drugs

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Leukemoid reaction WBC>50,000, or immature cells in PB Granulocyte, Lymphocyte Severe inflammation or infection

Leukoerythroblastic reaction Immature granulocyte and erythroblast in PB Myelofibrosis, BM metastastic tumor, Massive bleeding or hemolysis,

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Pelger-Huet anomaly

May-Hegglin anomaly ; Dohle body

Chediak Higashi syndrome

Chronic granulomatous disease (CGD)

Myeloperoxidase deficiency

http://blog.naver.com/hyouncho2/60105739704

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Toxic granules & vacuoles

Dohle body

Hypersegmentation &

Macrocytic neutrophil

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Diseases that decrease neutrophil production ( 생산감소 )

• Aplastic anemia• Toxins that damage marrow• Collagen vascular diseases (such as SLE) • Myelphthisic marrow processes such as marrow

infiltration by infections or metastatic carcinomas)• Hematologic malignancies such as leukemias• Myeloproliferative disorders• Radiation therapy, Chemotherapy• Congenital disorders

Diseases that increase neutrophil destruction ( 파괴증가 )

• Splenomegaly with hypersplenism• Infection• Immune destruction

Pseudoneutropenia http://blog.naver.com/hyouncho2/60105693613

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Acute myeloid leukemia (AML) and related neoplasms Myelodysplastic syndromes (MDS) Myeloproliferative neoplasms (MPN)

Myelodysplastic–myeloproliferative neoplasms (MDS/MPN) 

Myeloid/lymphoid neoplasms

             associated with eosinophilia and abnormalities of

PDGFRA, PDGFRB, or FGFR1

http://blog.naver.com/hyouncho2/60142413658

http://blog.naver.com/hyouncho2/60109241833