백혈구 구조, 기능 및 백혈구질환 http://blog.naver.com/hyouncho2/60088163283

백혈구 종류 Granulocyte : neutrophil, eosinoiphil, basophil Monocyte *mactophage histiocyte = tissue macrophage Lymphocyte *plasma cell

Differentiation of Myeloid Cells Pleuripotent stem cell (PST) → CFU-GEMM → CFU-GM → CFU-G → Myeloblast → promyelocyte → myelocyte → metamyelocyte → band neutophil → segmented neutrophil (eosinophil, basophil)

Myeloid Pools (compartments) Bone marrow : Stem cell pool: PSC – CFU-G Mitotic pool (5 ds ): myeloblast-myelocyte Post mitotic (reserve) pool (6.6 ds): metamyelocyte - seg.N Peripheral blood (9.5 hrs) : Circulating pool Marginated pool Tissue http://blog.naver.com/hyouncho2/60105729162

과립구(중성구) 구조 Primary granules: myeloperoxidase, lactoferrin, leukocyte adhesion receptors, ALP, defensin, azurophil-derived bactericidal factor (ADBF) Secondary granules: lysozyme, collagenase, plasmin activator Tertiary granules : adhesion molecules, gelatinase, C3b receptor Surface membrane: CD11/CD18 complex, receptors for opsonin, chemotaxin, GM-CSF, G-CSF, phospholipid(PGE2, leukotriene, etc) Cytoplasm: actin, myosin, tubulin

중성구 살균 기능 - 관여물질 Adhesion Cascade

Phagocytosis and Killing

과립구 기능 이상 Defects of chemotaxis : aspirin, alcohol, corticosteroids, leukemias, lazy leucocyte syndrome Defects of phagocytosis: lack of opsonization (hypogammaglobulinemia) Defects of killing: chronic granulomatous disease (cytochrome b558 def), myeloperoxidase def.

백혈구 수(/mL) 변화 Neutrophilia : >7,500 Neutropenia : <1,500 Severe neutropenia : <500 Agranulocytosis : <100 Eosinophilia : 직접계산 ; 350 이상, 백혈구 백분율로 환산 ; 500이상 Basophilia : 200 이상 Monocytosis : 1,000 이상 Lymphocytosis : 성인 4,000 이상, 소아 8,800 이상

Neutrophilia Infection Toxins: metabolic (uremia), drugs, chemicals Tissue destruction or necrosis: trauma, burns, myositis, vaculitis, infarction, neoplasia Metabolic disorder : uremia, eclampsia Hemorrhage, especially into a body cavity Rapid hemolysis Hematologic disorders: leukemias, myeloproliferative neoplasm Pseudoneutrophilia : physical stress, drugs

Leukemoid reaction WBC>50,000, or immature cells in PB Granulocyte, Lymphocyte Severe inflammation or infection Leukoerythroblastic reaction Immature granulocyte and erythroblast in PB Myelofibrosis, BM metastastic tumor, Massive bleeding or hemolysis,

과립구의 유전성질환 Pelger-Huet anomaly May-Hegglin anomaly ; Dohle body Chediak Higashi syndrome Chronic granulomatous disease (CGD) Myeloperoxidase deficiency http://blog.naver.com/hyouncho2/60105739704

과립구의 후천성이상 Toxic granules & vacuoles Dohle body Hypersegmentation & Macrocytic neutrophil

중성구감소증 Neutropenia Diseases that decrease neutrophil production (생산감소) Aplastic anemia Toxins that damage marrow Collagen vascular diseases (such as SLE) Myelphthisic marrow processes such as marrow infiltration by infections or metastatic carcinomas) Hematologic malignancies such as leukemias Myeloproliferative disorders Radiation therapy, Chemotherapy Congenital disorders Diseases that increase neutrophil destruction (파괴증가) Splenomegaly with hypersplenism Infection Immune destruction Pseudoneutropenia http://blog.naver.com/hyouncho2/60105693613

과립구의 악성질환 Acute myeloid leukemia (AML) and related neoplasms Myelodysplastic syndromes (MDS) Myeloproliferative neoplasms (MPN) Myelodysplastic–myeloproliferative neoplasms (MDS/MPN)  Myeloid/lymphoid neoplasms              associated with eosinophilia and abnormalities of PDGFRA, PDGFRB, or FGFR1 http://blog.naver.com/hyouncho2/60142413658 http://blog.naver.com/hyouncho2/60109241833