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WBC - Coggle Diagram

- - - - shift from MLP to CLP
      - lymphoprolif disorder
      - less common
        
        chronic Ag stim/inflamm (canine Ehrlichiosis)
        
        dec lympho apoptosis in absence of glucocorticoid horm
    - - Epi
        
        shift of lymphos from MLP to CLP as result of inc blood flow and dec in lympho margination to endothel
        
        transient and most often seen in cats and young horses
        
        typ mild to mod (1.5-2x RI)
      - lymphoprolif disorders
        
        result of neoplastic prolif of lymphoid c, primarily involving blood/BM or tis
        
        persis lymphocytosis in cattle
        
        can vary widely in magnitude, altho typ mod to mk (>2.5x RI)
      - less common
        
        young ani
        
        canine Ehrlichiosis
        
        hypoadrenocorticism
        
        thymoma
  - - - steroid
        
        result of 1) shift of lymphos from CLP to other pools, and 2) dec lympho produc
        
        most common cause of lymphopenia in most sp
      - acute inflamm
        
        shift of lymphos from CLP to other pools (incl shift to MLP), inc emigr of lymphos into tis and LN
      - minor
        
        depletion lymphopenia
        
        lymphopenia of lymphoid hypoplasia/aplasia
    - - acute inflamm
      - steroid
      - less common
        
        depletion
        
        lymphopenia or lymphoid hypoplasia
  - - - morph variants of sm to med sized, thought to rep activ B c capable of producing Ig
      - seen in response to Ag stim
      - charac by
        
        inc cytoplasmic vol and/or basophilia
        
        irreg nuclear shape
        
        perinuclear clear zone
        
        inc c size
    - - CD8+ T c or NK c
      - inflamm or neoplasia
    - - lysosomal storage dz or intoxication (locoweed)
  - - - marginated (MLP)
      - circu (CLP)
    - - composed of lymphos w/in spleen, LN
    - - composed on lymphos w/in non-lymphoid tis
  - - - sm
        
        smaller than neutro, most matu, most numerous (in health)
      - lg
        
        larger than neutro, lymphoblast if nucleolus present, and absent in periph blood of healthy ani
      - medium
        
        approx same size as neutro, uncommon in periph blood of healthy ani
      - rum have more heterog popu
- - - - inflamm
        
        LEFT SHIFT
        
        caused by: 1) release of c from SNP, 2) release of c from matNP, 3) inc produc
        
        inciting stim: infec, neoplasia, immu-medi dz, necrosis
        
        +/- toxic change
        
        magnitude dep on sp and stim
      - neoplasia
        
        primary = myeloprolif neoplasia (CGL/CML)
        
        secondary = paraneoplastic - tumor producing G-CSF
      - steroid (stress)
        
        caused by: 1) shift of neutros from MNP to CNP, 2) inc release of c from SNP to matNP
        
        results from endog or exog glucocorticoid and down-regu of adh molec
        
        may have mild L shift
      - Epi
        
        results from effects of catecholamines (fear, excitement, strenuous exercise) and is short lived, <1 hr
        
        seen most commonly in cats and horses
        
        caused by: shift of neutros from MNP to CNP
      - other: leukocyte adh defic of cattle and dogs
    - - shift of neutros from MNP to CNP
      - inc release of neutros from BM
      - inc produc of neutros from BM
    - - inflamm = any magnitude
      - steroid/stress = typ mild-moderate
      - Epi = typ mild-moderate
      - myeloid neoplasia = typ mk
      - impt to note process are ADDITIVE
        
        steroid/stress alone = mild-mod
        
        steroid/stress + inflamm = mild to mk
  - - - inflamm
        
        most commonly seen w acute inflamm
        
        often seen in cattle due to sm SNP
        
        results from migr of neutros into tis overwhelms the CNP, MNP, SNP
      - endotoxemia
        
        infec w Gram neg orgm
        
        stim shift of neutros from CNP to MNP
        
        effect is gen short lived (1-3 hrs after single exposure) and result of confounding factors = may not be present when seen by vet
      - dec produc
        
        result from stem c injury (reversible or irreversible), disorders that disrupt BM microenviron, and disorders of ineffective produc
        
        caused by chemotx, radiation, viruses, tickborne dz, neoplasms, immun-medi, BM necrosis or fibrosis, and other toxicities
        
        periph destruc is uncommon
      - less common
        
        Canine cyclic hematopoiesis
        
        autosomal recessive disorder of gray collies charac by regu (ev 11-14 d) episodes of neutropenia bc of muta in cytoplasmic trnspt prot
    - - shift from circu pool to marginating pool
      - overwhelming egress into tis (inflamm consump)
      - dec produc or release from BM
  - - - morph changes of neutros that dev in BM during episodes of inc produc
        
        no func defects
        
        toxic granules: retention of primary granules
        
        foamy cytoplasm: rep cytoplasmic clearing due to dispersed organelles
        
        cytoplasmic basophilia: persis of cytoplasmic RNA
        
        giant neutros: lg than norm that are released prematu
        
        Dohle bodies: aggreg of ER
      - severity graded 1+. 2+, 3+
      - altho commonly seen in inflamm, its absence should NOT be used to exclude inflamm consideration
    - - nucleus w 5+ lobes
        
        aging or inc glucocorticoids
    - - bact: morulae (Anaplasma, Ehrlichia)
      - viral: canine distemper virus
      - fungal: Histoplasma capsulatum
      - protozoal: Hepatazoon, Leishmania, Trypanosoma, Toxoplasma
    - - Pelger-Huet anomaly
        
        hereditary disorder in dogs, cats, and Arabian horses
        
        granuloctes are hyposeg
        
        need to disting from L shift (bands)
      - Chediak-Higashi synd
        
        autosomal recessive disorder affecting Persian cats, Hereford cattle, mink, whale
      - Birman cat neutro granulation anomaly
        
        autosomal recessive
      - mucopolysaccharides
        
        heritable, lysosomal storage disorders in dogs and cats
  - - - primary site of neutro produc in adult ani
      - common pluripotent stem c -> myeloblast -> progranulocyte -> myelocyte -> metamyelocyte -> band neutro -> seg neutro
      - 3 pools
        
        prolif (proNP) = c undergoing division and matur
        
        storage (SNP) = reserve of matur c
        
        dogs >> horse = cat > rum
        
        size of pool is impt - "emergency pool"
        
        matur (matNP) = c undergoing matur only
      - as mature, neutros become sm, nuclear chromatin condenses, and nuclei become elong and seg
      - myeloblast -> seg neutro takes 6-7 d in health, w inc stim/demand can be shortened to 2-5 d
      - regu by numerous cyk
    - - neutros migr unidirectionally into periph blood
      - 2 pools
        
        circu (CNP)
        
        c flowing in vascu = c that are quant during CBC
        
        marginated (MNP)
        
        temporarily adh to endothel wall = not quant during CBC
      - pools are dynamic, moving btwn CNP and MNP
      - MNP:CNP 1:1 in most sp
        
        3:1 in cats
      - half life ~ 6 hrs
    - - migr unidirectional into tis
      - most die in respir and alimentary
    - - 4 maj processes affec periph blood neutro conc
        
        1) produc
        
        2) release from BM
        
        3) distrib in periph blood compartment
        
        4) tis demand
  - - - regener L shift
        
        segs > bands
        
        neutro response is approp -> "compensated"
        
        ADEQUATE response
      - degener L shift
        
        bands > segs
        
        BM is not adeq responding to tis demand
        
        rum prone to this (sm SNP)
        
        "poorly compensated/uncompensated"
        
        INADEQUATE response
- - - - inc in glucocorticoids cause shift in periph blood monos from marginating pool to circu pool
    - - infec (bact, fungal, protozoal) or non-infec inflamm dz (hemolysis, neoplasia, infarc, trauma)
    - - monocytic leuk
  - - - func as APCs and capable of phago
      - particip in wound healing and chronic inflamm
- - - - infec w ecto or endoparasites (GI or heartworm) -> BUT INCONSISTENT
    - - allergic disorders - flea bite dermatitis and asthma -> BUT INCONSISTENT
    - - incl eosinophilic gastroenteritis, eosinophilic granuloma complex and hypereosinophilic synd
      - uncommon conditions which result in unexplained accum of eos w/in tis (GI tract) and/or periph blood -> need to disting from eos leuk
    - - degranul w/in sites of mast c inflamm (skin, GI, urinary tract, respir tract)
    - - eosinophilic leuk
      - paraneoplastic - mast c and other neoplasms (lymphoma, carcinoma, fibrosarcoma)
  - - - canine eos have highly varia granule # and size
      - feline eos have densely packed, rod-barrel shaped granules
      - equine eos have raspberry appearance due to lg round granules
      - ruminant eos have numerous, sm round granules
- - - - canine basos tend to be poorly granulated w sm #s of dk violet granules
      - feline basos have lg #s of densely packed gray granules
- - - - NO toxic change
      - cats 3-4x URL
      - magnitude typ 2x URL
    - - up to 2x URL
  - - - NO toxic change
      - mild L shift
      - magnitude = 2x URL or 3-4x URL for cats
      - hyperseg in inconsis finding
    - - THE MOST CONSIS FINDING IN STRESS LEUKOGRAM
    - - lymphopenia > mature neutrophilia > monocytosis > eosinopenia
  - - - leukocytosis
        
        mk inflamm response = leukemoid response
      - neutrophilia
        
        toxic change
        
        +/- L shift
      - +/- monocytosis
      - +/- lymphopenia
      - SNP, matNP, proNP adeq respond to inc periph blood demand
      - w chronicity, magnitude of L shift and severity of toxic change may dec as BM cont to compensate for periph demand
    - - neutropenia
        
        +/- L shift
        
        +/- toxic change
      - poor prognostic indicator in SA
      - not uncommon in LA b/c of small SNP and slow BM response
      - BM is incapable of keeping up w periph demand
    - - acute (early)
        
        leukopenia
        
        neutropenia
        
        may see lymphopenia
        
        most profound effects
      - late/rebound
        
        norm to inc total WBC conc
        
        norm to inc neutros conc
        
        +/- L shift and toxic change
        
        w/in hrs to d of stim
    - - changes reflect half life of affected lineages
        
        neutro 1/2 life in circu = 5-10 hrs = earliest to dec
        
        plt 1/2 life in circu = 5-10 d = 2nd to dec
        
        RBC 1/2 life in circu = 70-150 d = last to dec
      - lymphos are not primarily produc in BM and therefore may be WRI
- - - - cutaneous or visceral mast c neoplasia and mast c leuk
    - - non neoplastic probably more common than neoplastic
      - enteritis, dermatitis, pneumonia, pericarditis