White Blood cell pathology (paediatrics)
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White blood cell parameters[edit | edit source]
- leukocytosis : > 10,000,
- leukopenia : < 4,000,
- neutropenia: < 1,000 (in children 2 weeks to 1 year), < 1,500 (in children over 1 year),
- agranulocytosis: < 500,
- lymphocytosis: > 5,000,
- lymphopenia: < 1,500,
- monocytosis: > 800 or > 10% in diff.,
- eosinophilia: > 600 or > 10% in diff.,
- basophilia: > 100 or > 1% in diff.
Differential diagnosis of leukocytosis and neutrophilia[edit | edit source]
- pyogenic infection,
- connective tissue disease
- glomerulonephritis,
- acidosis,
- uremia,
- acute bleeding,
- hemolysis ,
- burns,
- surgery,
- liver necrosis,
- dehydration,
- corticoids,
- catecholamines,
- lead and mercury poisoning,
- bone marrow metastases .
Physiological causes of leukocytosis and neutrophilia[edit | edit source]
Leukemoid reaction[edit | edit source]
The leukemoid reaction represents a situation where we find several tens of thousands of leu/mm 3 + a significant shift to immature forms. Determination of ALP in neutrophils can help in differential diagnosis (in leukemia, ALP is reduced, in a leukemoid reaction as part of an infection or systemic disease, ALP is normal or increased). When in doubt , bone marrow aspiration brings certainty .
Differential diagnosis of lymphocytosis[edit | edit source]
- Absolute lymphocytosis
- infectious lymphocytosis,
- infectious mononucleosis,
- pertussis,
- Syphilis,
- TB,
- hyperthyroidism.
- relative lymphocytosis
Differential diagnosis of neutropenia[edit | edit source]
- congenital
- reticular dysgenesis,
- congenital pluripotent stem cell disorder,
- m. Kostmann,
- cyclic neutropenia,
- Schwachmann sy.,
- neutropenia during DMP: glycogenosis, m. Gaucher.
- gained
- isoimmune neonatal neutropenia,
- vitamin B12 deficiency,
- folic acid deficiency,
- autoimmune etiology,
- SLE ,
- JIA ,
- SCID ,
- Hyper IgM syndrome,
- Evans syndrome,
- lymphomas,
- drugs: chloramphenicol, antiepileptics, thyrostatics,
- infection: EBV, CMV, HHV 6, HIV, Parvovirus, hepatitis, varicella, parotitis,
- idiopathic neutropenia.
Differential diagnosis of eosinophilia[edit | edit source]
- Allergic diseases,
- skin diseases: atopic eczema,
- parasitic infections: toxocariasis, oxyuria,
- m. Hodgkin,
- scarlatina.
Links[edit | edit source]
Source[edit | edit source]
- HAVRÁNEK, Jiří: Hematology - general introduction. (edited)
