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Dr Pallavi Saxena
Objectives 
Introduction 
Leucopoiesis 
Classification 
Morphology 
Properties 
Functions 
Applied physiology 
Recent advances
Introduction 
 Why leucocytes called white cells?? 
Gabriel Andral,a French professor of medicine and 
William Addison, an English country 
practitioner,reported simultaneously the first 
description of leucocytes (1843) 
Play important role in immunity of the body
Leucopoiesis 
Definition 
The process of development and maturation of 
white blood cells(leucocytes), is called 
leucopoiesis.
HEAMOCYTOBLAST 
MYELOID SERIES 
MYELOID STEM 
CELL 
MYELOBLAST 
PROMYELOCYTE 
GRANULOPOIESIS 
MYELOCYTE 
METAMYELOCYTE 
BAND FORM 
GRANULOCYTE
HEAMOCYTOBLAST 
MYELOID STEM CELL 
MYELOMONOBLAST 
FORMATION OF 
MONOCYTES 
PROMONOCYTE 
MONOCYTE 
(BLOOD) 
MACROPHAGE 
(TISSUES) 
MONOCYTE-MACROPHAGE 
SERIES
HEAMOCYTOBLAST 
LYMPHOID STEM CELL 
LYMPHOBLAST 
LYMPHOPOIESIS 
PROLYMPHOCYTE 
LYMPHOCYTE 
PLASMA CELLS
Regulation of leucopoiesis 
Granulopenia or dead granulocytes & monocytes 
Releases 
G-CSF 
M-CSF 
GM-CSF 
Interleukins 
Stimulate 
Bone Marrow 
Increased formation 
Granulocytes 
Monocytes/macrophages 
Normal 
counts inhibit
Normal range of WBC 
At birth,in full term infant: 10,000-25,000/μl 
of blood 
Infants upto 1 yr of age:6000-16,000/μl of 
blood 
Adults:4000-11,000/μl of blood
Variations in WBC count 
TLC > 11,000/μL(Leucocytosis) 
Physiological 
1.Age 
2.Exercise 
3.Mental stress 
4.Pregnancy 
5.After food intake 
6.Exp.to low temp. 
Pathological 
1.Acute bacterial 
infections 
(pyogenic org.) 
2.Burns 
3.Post-operative 
period 
4.Tuberculosis 
5.Glandular fever
TLC < 4000/μL( Leucopenia) 
1.Infections by non-pyogenic organisms e.g. 
typhoid fever 
2.Viral infections, influenza,smallpox,mumps 
etc 
3.Protozoal infections 
4.Starvation & malnutrition 
5.Aplasia of bone marrow 
6.Bone marrow depression
Classification 
Granulocytes Agranulocytes 
Neutrophils 
Eosinophils 
Basophils 
Lymphocytes 
Monocytes
Neutrophils 
1. Cell size- 10-14μm 
2. Nucleus- central or eccentric; 2-6 
lobes;deep purplish blue 
3. Cytoplasm- faint pink 
4. Granules- fine(pin-point); violet- 
Normal values pink in color 
•Differential:40 
-75% 
•Absolute:2000 
-7500/μl of 
blood
Eosinophils 
1. Cell size- 10-14μm 
2. Nucleus- central or eccentric; 2-3 
lobes; purplish blue; “spectacle 
shaped” 
3. Cytoplasm- acidophilic;bright 
pink in color 
4. Granules- large; coarse; crimson 
red 
Normal values 
•Differential: 1- 
6% 
•Absolute:40- 
440/μl of blood
Basophils 
1. Cell size- 10-14μm 
2. Nucleus- central; 2-3 lobes; 
purplish blue; overlaid with 
granules 
3. Cytoplasm- basophilic; full of 
granules 
4. Granules- very coarse,deep 
purple or blue 
Normal values 
•Differential: 0- 
1% 
•Absolute: 0- 
100/μl of blood
Monocyte 
1. Cell size- 12-20μm 
2. Nucleus- eccentric or central; 
round or oval; pale bluish 
violet 
3. Cytoplasm- abundant; pale 
blue; clear 
Normal values 
•Differential: 
2-10% 
•Absolute:500 
-800/μl of 
blood
Lymphocyte 
1. Cell size- LL:12-16μm; SL:7- 
10μm 
2. Nucleus- eccentric; large 
round nucleus; deep purplish 
blue 
3. Cytoplasm- scanty; light blue 
color 
Normal values 
•Differential:2 
0-40% 
•Absolute: 
1500-4000/μl 
of blood
Variation in counts 
Neutrophilia 
Absolute count > 
10,000/μl of blood 
•Physiological & 
•Pathlogical causes 
Neutropenia 
Absolute count< 
2500/μl of blood 
•Causes??
Life Span Of WBC 
Not constant. 
 Neutrophils -> 2-5 days 
 Eosinophils -> 7-12 days 
 Basophils -> 12-15 days 
 Monocytes -> 2-5 days 
 Lymphocytes -> ½-1 day
Properties Of WBC’s 
 Diapedesis 
 Ameboid movement 
 Chemotaxis 
 Phagocytosis
Properties of WBCs
FUNCTIONS
Neutrophils 
 1st line of defense 
 Granules contain enzymes like 
Nucleotidases 
Catalases 
 Antibody like substances -> Defensins
Eosinophils 
 Defense (specially against parasites ) 
 Role in allergic reactions 
 Substances present in granules 
1. Major basic protein 
2. Eosinophilic cationic proteins 
3. Eosinophil peroxidase 
4. Aryl sulphatase B
Basophils 
 Role in allergic responses 
 Substances present in granules 
1. Histamine 
2. Heparin 
3. Hyaluronic acid 
4. Proteases & Myeloperoxidase
Monocytes 
 1st line of defense 
 Motile & phagocytic 
 Precursors of tissue macrophages 
secrete: 
1. Interleukin 1 
2. Colony stimulating factor 
3. Platelet activating factor
Lymphocytes 
Immunity 
1.T- Lymphocyte -> Cellular Immunity 
2.B- Lymphocyte -> Humoral Immunity
APPLIED 
PHYSIOLOGY
Variation in counts 
Neutrophilia 
Absolute count > 
10,000/μl of blood 
•Physiological & 
•Pathlogical causes 
Neutropenia 
Absolute count< 
2500/μl of blood 
•Causes??
Variation in counts 
Eosinophilia 
•Absolute count 
> 500/μl of 
blood 
•Causes?? 
Eosinopenia 
•Absolute count < 
50/μl of blood 
•Causes..??
Cont…. 
Basophilia 
•Absolute 
count >100/μl 
of blood 
•Causes 
Basopenia 
•Decrease in 
basophil count 
•Causes
Lymphocytosis 
•Absolute count> 
4000/μl of blood 
•Physiological 
•Pathological 
causes 
Lymphopenia 
•Absolute 
count < 
1500/μl of 
blood 
•Causes??
Monocytosis 
•Count > 800/μl 
of blood 
•Causes?? 
Monocytopenia 
•Decrease in 
monocyte count 
•Rare
PATHOLOGICAL 
VARIATIONS
CYCLIC NEUTROPENIA 
 Episodes of severe neutropenia usually 
lasting for 3-6 days 
Can be familial & inherited with maturation 
arrest
Hypereosinophilic syndrome 
Criteria of diagnosis 
Peripheral blood eosinophil >1.5 x 109/L 
Persistence of counts more than 6 months 
Organs involved 
Heart 
Lung 
Skin 
Neurological
LEUCOCYTES BENIGN DISORDERS 
Qualitative changes (MORPHOLOGY) 
Congenital 
Pelger-Huet anomaly 
Bilobed and occasional unsegmented 
neutrophils 
Autosomal recessive disorder
Chediak-Higashi syndrome 
Autosomal recessive disorder 
Giant granules in granulocytes, monocytes and 
lymphocytes 
Recurrent pyogenic infections 
Lymphoproliferative syndrome may develop 
Treatment is BMT
Leukemia 
 WBC upto 1,000,00/cu.mm 
 It can be – 
1. Acute – Lmphoblastic 
Myeloblastic 
2. Chronic – Lymphatic 
Myeloid
RECENT 
ADVANCES
1.Bone marrow transplantation 
2.Apheresis & leucocyteapheresis 
3.Use of special filters & leucocyte depleted 
blood 
4.Flow cytometry 
5.Alpha interferon
Bibliography 
Essentials of medical physiology by 
K.Sembulingam & Prema Sembulingam 
Medical physiology by Guyton & Hall 
Medical physiology by Indu Khurana 
Google search

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White blood cells

  • 2. Objectives Introduction Leucopoiesis Classification Morphology Properties Functions Applied physiology Recent advances
  • 3. Introduction  Why leucocytes called white cells?? Gabriel Andral,a French professor of medicine and William Addison, an English country practitioner,reported simultaneously the first description of leucocytes (1843) Play important role in immunity of the body
  • 4. Leucopoiesis Definition The process of development and maturation of white blood cells(leucocytes), is called leucopoiesis.
  • 5. HEAMOCYTOBLAST MYELOID SERIES MYELOID STEM CELL MYELOBLAST PROMYELOCYTE GRANULOPOIESIS MYELOCYTE METAMYELOCYTE BAND FORM GRANULOCYTE
  • 6. HEAMOCYTOBLAST MYELOID STEM CELL MYELOMONOBLAST FORMATION OF MONOCYTES PROMONOCYTE MONOCYTE (BLOOD) MACROPHAGE (TISSUES) MONOCYTE-MACROPHAGE SERIES
  • 7. HEAMOCYTOBLAST LYMPHOID STEM CELL LYMPHOBLAST LYMPHOPOIESIS PROLYMPHOCYTE LYMPHOCYTE PLASMA CELLS
  • 8. Regulation of leucopoiesis Granulopenia or dead granulocytes & monocytes Releases G-CSF M-CSF GM-CSF Interleukins Stimulate Bone Marrow Increased formation Granulocytes Monocytes/macrophages Normal counts inhibit
  • 9. Normal range of WBC At birth,in full term infant: 10,000-25,000/μl of blood Infants upto 1 yr of age:6000-16,000/μl of blood Adults:4000-11,000/μl of blood
  • 10. Variations in WBC count TLC > 11,000/μL(Leucocytosis) Physiological 1.Age 2.Exercise 3.Mental stress 4.Pregnancy 5.After food intake 6.Exp.to low temp. Pathological 1.Acute bacterial infections (pyogenic org.) 2.Burns 3.Post-operative period 4.Tuberculosis 5.Glandular fever
  • 11. TLC < 4000/μL( Leucopenia) 1.Infections by non-pyogenic organisms e.g. typhoid fever 2.Viral infections, influenza,smallpox,mumps etc 3.Protozoal infections 4.Starvation & malnutrition 5.Aplasia of bone marrow 6.Bone marrow depression
  • 12. Classification Granulocytes Agranulocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes
  • 13. Neutrophils 1. Cell size- 10-14μm 2. Nucleus- central or eccentric; 2-6 lobes;deep purplish blue 3. Cytoplasm- faint pink 4. Granules- fine(pin-point); violet- Normal values pink in color •Differential:40 -75% •Absolute:2000 -7500/μl of blood
  • 14. Eosinophils 1. Cell size- 10-14μm 2. Nucleus- central or eccentric; 2-3 lobes; purplish blue; “spectacle shaped” 3. Cytoplasm- acidophilic;bright pink in color 4. Granules- large; coarse; crimson red Normal values •Differential: 1- 6% •Absolute:40- 440/μl of blood
  • 15. Basophils 1. Cell size- 10-14μm 2. Nucleus- central; 2-3 lobes; purplish blue; overlaid with granules 3. Cytoplasm- basophilic; full of granules 4. Granules- very coarse,deep purple or blue Normal values •Differential: 0- 1% •Absolute: 0- 100/μl of blood
  • 16. Monocyte 1. Cell size- 12-20μm 2. Nucleus- eccentric or central; round or oval; pale bluish violet 3. Cytoplasm- abundant; pale blue; clear Normal values •Differential: 2-10% •Absolute:500 -800/μl of blood
  • 17. Lymphocyte 1. Cell size- LL:12-16μm; SL:7- 10μm 2. Nucleus- eccentric; large round nucleus; deep purplish blue 3. Cytoplasm- scanty; light blue color Normal values •Differential:2 0-40% •Absolute: 1500-4000/μl of blood
  • 18. Variation in counts Neutrophilia Absolute count > 10,000/μl of blood •Physiological & •Pathlogical causes Neutropenia Absolute count< 2500/μl of blood •Causes??
  • 19. Life Span Of WBC Not constant.  Neutrophils -> 2-5 days  Eosinophils -> 7-12 days  Basophils -> 12-15 days  Monocytes -> 2-5 days  Lymphocytes -> ½-1 day
  • 20. Properties Of WBC’s  Diapedesis  Ameboid movement  Chemotaxis  Phagocytosis
  • 23. Neutrophils  1st line of defense  Granules contain enzymes like Nucleotidases Catalases  Antibody like substances -> Defensins
  • 24. Eosinophils  Defense (specially against parasites )  Role in allergic reactions  Substances present in granules 1. Major basic protein 2. Eosinophilic cationic proteins 3. Eosinophil peroxidase 4. Aryl sulphatase B
  • 25. Basophils  Role in allergic responses  Substances present in granules 1. Histamine 2. Heparin 3. Hyaluronic acid 4. Proteases & Myeloperoxidase
  • 26. Monocytes  1st line of defense  Motile & phagocytic  Precursors of tissue macrophages secrete: 1. Interleukin 1 2. Colony stimulating factor 3. Platelet activating factor
  • 27. Lymphocytes Immunity 1.T- Lymphocyte -> Cellular Immunity 2.B- Lymphocyte -> Humoral Immunity
  • 29. Variation in counts Neutrophilia Absolute count > 10,000/μl of blood •Physiological & •Pathlogical causes Neutropenia Absolute count< 2500/μl of blood •Causes??
  • 30. Variation in counts Eosinophilia •Absolute count > 500/μl of blood •Causes?? Eosinopenia •Absolute count < 50/μl of blood •Causes..??
  • 31. Cont…. Basophilia •Absolute count >100/μl of blood •Causes Basopenia •Decrease in basophil count •Causes
  • 32. Lymphocytosis •Absolute count> 4000/μl of blood •Physiological •Pathological causes Lymphopenia •Absolute count < 1500/μl of blood •Causes??
  • 33. Monocytosis •Count > 800/μl of blood •Causes?? Monocytopenia •Decrease in monocyte count •Rare
  • 35. CYCLIC NEUTROPENIA  Episodes of severe neutropenia usually lasting for 3-6 days Can be familial & inherited with maturation arrest
  • 36. Hypereosinophilic syndrome Criteria of diagnosis Peripheral blood eosinophil >1.5 x 109/L Persistence of counts more than 6 months Organs involved Heart Lung Skin Neurological
  • 37. LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) Congenital Pelger-Huet anomaly Bilobed and occasional unsegmented neutrophils Autosomal recessive disorder
  • 38. Chediak-Higashi syndrome Autosomal recessive disorder Giant granules in granulocytes, monocytes and lymphocytes Recurrent pyogenic infections Lymphoproliferative syndrome may develop Treatment is BMT
  • 39. Leukemia  WBC upto 1,000,00/cu.mm  It can be – 1. Acute – Lmphoblastic Myeloblastic 2. Chronic – Lymphatic Myeloid
  • 41. 1.Bone marrow transplantation 2.Apheresis & leucocyteapheresis 3.Use of special filters & leucocyte depleted blood 4.Flow cytometry 5.Alpha interferon
  • 42. Bibliography Essentials of medical physiology by K.Sembulingam & Prema Sembulingam Medical physiology by Guyton & Hall Medical physiology by Indu Khurana Google search