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Chapter: Medicine Study Notes : Haematology and Immunology

Haematology of Systemic Disease

E.g. Cancer -> ­ESR, ­Neutrophils, ­coagulation, anaemia

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


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