Leukocyte parameters of blood - Causes, symptoms and treatment. MF.

Leukocytes( white blood cells, white blood cells, WBC)

Leukocytes are blood cells that are responsible for the recognition and neutralization of foreign components, immune defense of the body against viruses and bacteria, and the elimination of the dying cells of one's own organism. The formation of leukocytes( leukopoiesis) takes place in the bone marrow and lymph nodes.

There are 5 types of leukocytes: neutrophils, lymphocytes, monocytes, eosinophils, basophils. Calculation of the percentage of these forms is carried out at the appointment of the test leukocyte formula. The number of white blood cells during the day can vary under the influence of various factors, without, however, exceeding the limits of reference values.

Physiological elevation of leukocyte level( physiological leukocytosis) occurs when they enter the bloodstream from blood depots, such as after meals( so it is desirable to perform an analysis on an empty stomach), after physical exertion( physical efforts are not recommended before taking blood) and in the second halfday( it is desirable to take blood for analysis in the morning), with stress, exposure to cold and heat. In women, a physiological increase in the number of leukocytes is noted in the premenstrual period, in the second half of pregnancy and during childbirth. Reactive physiological leukocytosis is provided by redistribution of the parietal and circulating pools of neutrophils, mobilization of the medullary pool. With the stimulation of leukopoiesis under the action of infectious agents, toxins, under the influence of inflammation and tissue necrosis factors, endogenous toxins, the number of leukocytes grows due to an increase in their formation in the bone marrow and lymph nodes. Some infectious and pharmacological agents can cause a decrease in the white blood cell count( leukopenia).The absence of leukocytosis in the acute phase of an infectious disease, especially when there is a left shift in the leukocyte formula( increased content of young forms) is an unfavorable sign. Leukocytosis can develop as a result of tumor processes in the hematopoietic tissue( leukemic proliferation of cells with the appearance of blast forms).Hematological diseases can also occur in leukopenia. Leukocytosis and leukopenia usually develop as a consequence of the predominant increase or decrease in individual types of leukocytes( see Leukocyte formula).

Units of measurement: kcal / μL( x 10 3 cells / μl).
Alternative units of measurement: 109 cells / liter.
Conversion factor: 109 cells / L = 10 3 cells / μL = Thousand / μL.

Reference values:

Level increase( leukocytosis):

reactive( physiological)leukocytosis:

1. exposure to physiological factors( pain, cold or hot bath, physical stress, emotional stress, exposure to sunlight and UV rays);
2. condition after surgery;
3. menstruation;
4. the period of childbirth.

leukocytosis as a result of leukopoiesis stimulation:

1. infectious and inflammatory processes( osteomyelitis, pneumonia, tonsillitis, sepsis, meningitis, phlegmon, appendicitis, abscess, polyarthritis, pyelonephritis, peritonitis) of bacterial, viral or fungal etiology;
2. intoxication, including endogenous( diabetic acidosis, eclampsia, uremia, gout);
3. burns and injuries;
4. acute bleeding;
5. surgical interventions;
6. infarctions of internal organs( myocardium, lungs, kidneys, spleen), rheumatic attack;
7. malignant tumors;
8. glucocorticoid therapy;
9. acute and chronic anemia of various etiologies( hemolytic, autoimmune, posthemorrhagic);

tumor leukocytosis: myelo- and lymphocytic leukemia.

Level lowering( leukopenia):

1. some viral and bacterial infections( influenza, typhoid fever, tularemia, viral hepatitis, sepsis, measles, malaria, rubella, mumps, miliary tuberculosis, AIDS);
2. systemic lupus erythematosus, rheumatoid arthritis and other collagenoses;
3. reception of sulfonamides, levomycetin, analgesics, non-steroidal anti-inflammatory drugs, thyreostatics, cytostatics;
4. exposure to ionizing radiation;
5. leukopenic forms of leukemia;
6. splenomegaly, hypersplenism, condition after splenectomy;
7. hypo- and aplasia of bone marrow;
8. Addison-Birmer disease;
9. anaphylactic shock;
10. depletion and cachexia;
11. pernicious anemia;
12. Felty Syndrome;
13. Gauchers disease;
14. paroxysmal nocturnal hemoglobinuria.

Leukoformula Leukocytes( white blood cells, white blood cells)

Leukocytes are blood cells associated with protective functions. According to the morphological features( the type of nucleus, the presence and nature of cytoplasmic inclusions), five main types of leukocytes are isolated: neutrophils, lymphocytes, monocytes, eosinophils and basophils. In addition, leukocytes differ in their degree of maturity. Most of the precursor cells of mature leukocyte forms( young, myelocytes, promyelocytes, blast cells), as well as plasma cells, young nuclear cells of the erythroid series, etc. appear in the peripheral blood only in the case of pathology. Different types of leukocytes perform different functions, so the determination of the ratio of different types of leukocytes, the content of young forms, the identification of pathological cellular forms, a description of the characteristic changes in the morphology of cells reflecting the change in their functional activity, carries valuable diagnostic information.

Some variants of change( shift) of the leukocyte formula:

• left shift ( in the blood there is an increased number of stab neutrophils, possibly the appearance of metamyelocytes( young), myelocytes)) may indicate: acute infectious diseases;physical overstrain;acidosis and coma. right shift ( in the blood there are hypersegmented granulocytes) may indicate: megaloblastic anemia;kidney and liver diseases;condition after a blood transfusion. significant rejuvenation of cells( in the blood there are metamyelocytes, myelocytes, promyelocytes, blast cells) may indicate: chronic leukemia;erythroleukemia;myelofibrosis;metastasis of malignant neoplasms;acute leukemia.

Change in the level of individual leukocyte populations:

Neutrophilia - an increase in the total number of leukocytes due to neutrophils.

Neutropenia is a decrease in the neutrophil count.

Lymphocytosis - an increase in the lymphocyte count.

Lymphocytopenia is a decrease in lymphocyte count.

Eosinophilia - an increase in the content of eosinophils.

Eosinopenia - decrease in the content of eosinophils.

Monocytosis - an increase in the monocyte content.

Monopotency( monocytopenia) is a decrease in monocyte content.

Neutrophils

Neutrophils are the most numerous type of white blood cells, they account for 50-75% of all leukocytes. They are also named for the appearance of cytoplasmic granules during Giemsa staining. Depending on the degree of maturity and the shape of the nucleus in the peripheral blood, they release the stabnuclear( younger) and segment-nuclear( mature) neutrophils. The younger cells of the neutrophilic series - young( metamyelocytes), myelocytes, promyelocytes - appear in the peripheral blood in the case of pathology and are evidence of stimulation of the formation of cells of this species. Their main function is protection from infections by chemotaxis( directed movement to stimulating agents) and phagocytosis( absorption and digestion) of foreign microorganisms.

Reference values:

in children and adults depending on age

Increased neutrophil count( neutrophilia, neutrophilia):

1. infections( caused by bacteria, fungi, protozoa, rickettsia, certain viruses, spirochetes);inflammatory processes( rheumatism, rheumatoid arthritis, pancreatitis, dermatitis, peritonitis, thyroiditis);condition after surgery;ischemic necrosis of tissues( myocardial infarctions of the internal organs, kidneys, etc.);endogenous intoxications( diabetes mellitus, uremia, eclampsia, necrosis of hepatocytes);physical stress and emotional stress and stressful situations: exposure to heat, cold, pain, burns and childbirth, pregnancy, fear, anger, joy;oncological diseases( tumors of various organs);taking certain medications, for example, corticosteroids, digitalis preparations, heparin, acetylcholine;poisoning with lead, mercury, ethylene glycol, insecticides.

Lowering the neutrophil count( neutropenia):

1. Some infections caused by bacteria( typhoid and paratyphoid, brucellosis), viruses( influenza, measles, chickenpox, viral hepatitis, rubella), protozoa( malaria), rickettsia( typhus), protractedinfections in elderly and debilitated people;diseases of the blood system( hypo- and aplastic, megaloblastic and iron deficiency anemia, paroxysmal nocturnal hemoglobinuria, acute leukemia, hypersplenism);congenital neutropenia( hereditary agranulocytosis);Chediak Higashi syndrome;anaphylactic shock;thyrotoxicosis;the effect of cytostatics, antitumor drugs;drug neutropenia associated with the increased sensitivity of individuals to the action of certain medicines( nonsteroidal anti-inflammatory drugs, anticonvulsants, antihistamines, antibiotics, antiviral agents, psychotropic drugs, drugs affecting the cardiovascular system, diuretics, antidiabetic drugs).

Lymphocytes

Lymphocytes are a population of leukocytes that provide immune surveillance( recognition of "one's own"), the formation and regulation of the humoral and cellular immune response, the provision of immune memory. Relate to agranulocytes( do not contain granules in the cytoplasm).Lymphocytes account for 20-40% of the total number of leukocytes. They are capable of recognizing various antigens due to the presence of special receptors on the cell surface. Different subpopulations of lymphocytes perform various functions - they provide effective cellular immunity( including transplant rejection, destruction of tumor cells), humoral response( in the form of synthesis of antibodies to foreign proteins - immunoglobulins of various classes).Lymphocytes through the isolation of protein regulators - cytokines participate in the regulation of the immune response and coordination of the work of the entire immune system as a whole, these cells are associated with the provision of immunological memory( the ability of the body to accelerate and strengthen the immune response when re-encountering a foreign agent).

IMPORTANT! It should be borne in mind that the leukocyte formula reflects the relative( percentage) content of leukocytes of different species, and an increase or decrease in the percentage of lymphocytes may not reflect true( absolute) lymphocytosis or lymphocytopenia, but be a consequence of a decrease or increase in the absolute number of leukocytes of other speciesneutrophils).

Reference values:

in children and adults, depending on age

Increase in lymphocyte level:

1. infectious diseases: infectious mononucleosis, viral hepatitis, cytomegalovirus infection, whooping cough, ARVI, toxoplasmosis, herpes, rubella, HIV infection;diseases of the blood system: acute and chronic lymphocytic leukemia;lymphosarcoma, heavy chain disease - Franklin's disease;poisoning with tetrachloroethane, lead, arsenic, carbon disulphide;treatment with drugs such as levodopa, phenytoin, valproic acid, narcotic analgesics.

Lowering the level of lymphocytes( lymphopenia):

1. acute infections and diseases;miliary tuberculosis;loss of lymph through the intestine;lymphogranulomatosis;systemic lupus erythematosus;aplastic anemia;kidney failure;terminal stage of oncological diseases;immunodeficiencies( with T-cell deficiency);X-ray therapy;taking drugs with cytostatic action( chlorambucil, asparaginase), glucocorticoids, the introduction of antilymphocyte serum.

Eosinophils

Eosinophils( cytoplasmic granules stained with acid dyes) are leukocytes involved in the body's reaction to parasitic, allergic, autoimmune, infectious and oncological diseases. Eosinophilic shifts in leukoformula occur when the allergic component is included in the pathogenesis of the disease, which is accompanied by hyperproduction of IgE.These cells are involved in tissue reactions in which parasites or IgE antibodies are involved, they have a cytotoxic effect on parasites. Estimation of the dynamics of changes in the number of eosinophils during the inflammatory process is of prognostic significance.

Eosinopenia ( a decrease in the number of eosinophils in the blood of less than 0.2x109 / L) is often observed at the onset of inflammation.

Eosinophilia ( an increase in the number of eosinophils & gt; 5%) corresponds to the onset of recovery. However, a number of infectious and other diseases with a high IgE level are characterized by eosinophilia after the end of the inflammatory process, which indicates the incompleteness of the immune reaction with its allergic component. At the same time, a decrease in the number of eosinophils in the active phase of the disease often indicates the severity of the process and is an unfavorable sign. In general, the change in the number of eosinophils in peripheral blood is the result of an imbalance in the processes of cell production in the bone marrow, their migration and decay in tissues.

Reference values:

in children and adults, depending on age

Increased level( eosinophilia):

1. allergic sensitization of the body( bronchial asthma, allergic rhinitis, pollinosis, atopic dermatitis, eczema, eosinophilic granulomatous vasculitis, food allergy);
2. drug allergy( often on the following drugs - aspirin, euphyllin, prednisolone, carbamazepine, penicillins, levomycetin, sulfonamides, tetracyclines, antituberculosis drugs);
3. skin diseases( eczema, herpetiform dermatitis);parasitic - helminth and protozoal - invasions( giardiasis, echinococcosis, ascariasis, trichinosis, strongyloidiasis, opisthorchiasis, toxocarosis, etc.);
4. acute period of infectious diseases( scarlet fever, chicken pox, tuberculosis infectious mononucleosis, gonorrhea);
5. malignant tumors( especially metastatic and with necrosis);proliferative diseases of the hematopoietic system( lymphogranulomatosis, acute and chronic leukemia, lymphoma, polycythemia, lymphogranulomatosis, myeloproliferative diseases, condition after splenectomy, hypereosinophilic syndrome);
6. inflammatory processes of connective tissue( nodular periarteritis, rheumatoid arthritis, systemic scleroderma);
7. lung diseases - sarcidosis, pulmonary eosinophilic pneumonia, histiocytosis from Langer cells, eosinophilic pleurisy, pulmonary myocardial eosinophilusfarction( adverse trait).

Decrease in level( eosinopenia):

initial phase of the inflammatory process, severe purulent infections;shock, stress;intoxication with various chemical compounds, heavy metals.

Monocytes

Monocytes are the largest cells among leukocytes, do not contain granules. They participate in the formation and regulation of the immune response, performing the function of presentation of the antigen to lymphocytes and being a source of biologically active substances, including regulatory cytokines. Have the ability to local differentiation - are the precursors of macrophages( which are transformed after leaving the bloodstream).Monocytes make up 2-10% of all leukocytes, are capable of amoeboid movement, show pronounced phagocytic and bactericidal activity. Macrophages can absorb up to 100 microbes, while neutrophils are only 20 to 30. They appear in the inflammatory focus after neutrophils and show a maximum of activity in an acid medium in which neutrophils lose their activity. In the focus of inflammation, macrophages phagocytize microbes, as well as dead leukocytes, damaged cells of inflamed tissue, clearing the inflammation focus and preparing it for regeneration. For this function, monocytes are called "janitors of the body."

Reference values:

in children and adults, depending on age

Increase in monocyte level( monocytosis):

1. infection( viral, fungal, protozoal and rickettsial aetiology), as well as the period of convalescence after acute infections;granulomatosis: tuberculosis, syphilis, brucellosis, sarcoidosis, ulcerative colitis( nonspecific);
2. systemic collagenoses( systemic lupus erythematosus), rheumatoid arthritis, nodular periarteritis;
3. blood diseases( acute monocytic and myelomonocytic leukemia, myeloproliferative diseases, myeloma, lymphogranulomatosis);
4. poisoning with phosphorus, tetrachloroethane.

Monocyte level lowering( monocytopenia):

1. aplastic anemia( bone marrow injury);
2. hairy cell leukemia;
3. pyogenic infections;
4. childbirth;
5. surgical interventions;
6. shock states;
7. reception of glucocorticoids.

Basophils( Basophilis)

The smallest population of leukocytes. Granules are stained with basic dyes. Basophils are involved in allergic and cellular inflammatory reactions of delayed type in the skin and other tissues, causing hyperemia, formation of exudate, increased permeability of capillaries. Contain such biologically active substances as heparin and histamine( similar to mast cells of connective tissue).Basophilic leukocytes during degranulation initiate the development of an anaphylactic hypersensitivity reaction of immediate type.

Reference values: 0 - 1%.

Increase in the level of basophils( basophilia):

1. chronic myelogenous leukemia( eosinophil-basophilic association);
2. myxedema( hypothyroidism);
3. chicken pox;hypersensitivity to food or medicines;
4. reaction to the introduction of a foreign protein;
5. nephrosis;
6. chronic hemolytic anemia;
7. condition after splenectomy;
8. Hodgkin's disease;
9. treatment with estrogens, antithyroid drugs;
10. ulcerative colitis.