26.2.9. Give the examples of neutrophillic, eosynophillic, basophillic, lymphocytic and monocytic leukocytosis:

Neutrophilic leukocytosis is characteristic for: purulent – inflammatory processes caused by pyogenic bacteria (abscesses, phlegmones, sepsis); oxygen starvation (huge bleeding, acute hemolysis); endogenic intoxication (uremia).

Eosinophilic leukocytosis develops at: allergic reactions of the 1^st type due to classification Coombs and Gell; helmintosis; chronic myeloleukemia.

Basophilic leukocytosis develops very seldom. It may accompany the development of: chronic myeloleukemia; hemophilia; Vakese’ disease (polycytemia)

Lymphocytic leukocytosis develops at: acute infectious diseases (whooping cough, virable hepatitis); some chronic infectious diseases (tuberculosis, syphilis, brucellosis); chronic lympholeukemia

Monocytic leukocytosis is characteristic for: chronic infections (tuberculosis, brucellosis); infectious mononeucleosis; infections caused by ricketsia and protosoa (epidemic typhus, malaria)

26.2.10. What is leukopenia? How is it classified?

Leukopenia is the decreased number of leukocytes in peripheral blood below 4•10⁹/l. Leukopenia is very often a manifestation of a disease. Though there are nosologic units where leukopenia is the leading manifestation of a disease, factually defining its clinical course and the rest of the symptoms.

Classifications of leukopenia:

1. According to the origin it may be acquired and hereditary. Acquired leukopenia mat be mediated by physical (ionizing radiation), chemical (benzol, cytostatics, drugs), biological (hepatic viruses, infectious mononeucleosis) and immune factors. The examples of hereditary leukopenia are Kostman’s granulopenia inherited granulopenia of autosomno-dominant type, syndrome of “lazy leukocytes”, cyclic granulopenia.

2. According to the type of leukocytes the number of which is decreased:

granulocytopenia, lymphopenia, eosinopenia.

3. According to pathogenesis:

leukopenia mediated by disorders of admission of leukocytes from the red bone marrow into the blood;

leukopenia related with the shortering of term existence of leukocytes in peripheral blood;

redistributive leukopenia.

4. There are several clinico-hematologic syndromes, where leukopenia is the leading sign. Among them are agranulocytosis, hypoplastic anemia, hemorrhagic aleikia.

26.2.11. What mechanisms are at the bases of development of leukopenia connected with the disorders of leukocytes admission from the red bone marrow into the blood?

1. Impairments of hemolytic cells. In this case myelotoxic leukopenia develops. There are three main mechanisms of hemolytic cell impairments:

a) cytolitic is connected with the effect of ionic radiation, cytostatic medicines, immune factors (antibodies, T-lymphocytes) on the cells. The lead of impairment of red bone marrow in this case develops on the dose and longevity of action of these factors.

b) antimetabolic. At its basis there are agents which interrupt the exchange of purine and pyramidal basements breaking the processes of trunk cell division. According to this principle some antineoplastic medicines and antibiotics act.

c) idiosyncratic, is realized at repeated introduction of drugs. The sensitivity of the organism to which is increased. More often these are drugs containing benzene rings in their structure. In case of idiosyncrasy there is no relation between the probability of the development of leukopenia and dose as well as the term of drug effect.

2. Disorders of mitosis – ineffective leukopoiesis. The most common causes are:

a) insufficiency of substances necessary for cell diversion, particularly vitamin B₁₂ and folic acid

b) disorders of mitosis regulation – deficiency of leukopoietins

3. Disorders of leukocyte maturation. The cause of it may be genetically mediated defects of hemolytic cells themselves (for example, Kostman’s neutropenia), as well as the cells of “microinvirenment” (for example, leukopenia in “steal” mice of SL/SL^d line). Alongside, the cell maturation reaches a certain stage (for example, promielocytes) and stops.

4. Disorders of leukocyte exit from red bone marrow into the blood. Similar disorders are often connected with genetic defects of leukocytes breaking their main functions and properties (mobility). The examples are the syndrome of “lazy” leukocytes, neutropenia of Jemen Jews.

5. Decrease of the plazdarm of leukopoiesis, takes place at replacing hemolytic tissue by leukemic cells, metastases of neoplasia etc.