Haematology of Systemic Disease

Haematology of Systemic Disease

·        E.g. Cancer ® ­ESR, ­Neutrophils, ­coagulation, anaemia

Erythrocyte Sedimentation Rate (ESR)

·        Normal varies by age and sex (increases with age)

·        Rouleaux: red cells stack like coins, fall fast

·        Due to:

o   Acute phase reactants: esp. fibrinogen

o   Gamma globulins

o   Anaemia 

·        Clinical uses: collaborative test, monitor course of disease 

·        ­ESR in pregnancy, infection, tumours, connective tissue disorders, multiple myeloma

Leucocytosis

·        Normal range varies with age (esp. kids)

·        Neutrophils:

o  In adults: 2 – 7.5 *10E9

o  Lobed nucleus, lots of granules in cytoplasm

o  Made in marrow, transported via blood 

o  Neutrophilia in many states, not just infection, and including stress. Physiological neutrophilia e.g. exercise ® ¯margination

Lymphocytosis

·        In acute infections: pertussis, infectious lymphocytosis, EBV, viral hepatitis

·        In chronic infections: brucellosis, Tb, Syphilis

·        In haemopoietic disorders 

·        Toxic Changes (i.e. „switched on‟): ­granules, vacuoles, Dohle bodies (blue clumps in cytoplasm), nuclear clumping. Strong indicator of bacterial infection