Variations in Number Normal Values for adult Caucasian

Variations in Number

Normal Values: for adult Caucasian Total leukocytes 4. 0 -11. 0 X 10 9/l Neutrophils 2. 5 -7. 5 X 10 9/l Eosinophils 0. 04 - 0. 4 X 10 9/l Monocytes 0. 2 - 0. 8 X 10 9/l Basophils 0. 01 -0. 1 X 10 9/l Lymphocytes 1. 5 -3. 5 X 10 9/l Normal black and Middle Eastern subjects may have lower counts due to margination. 2

Variations in Number: Neutrophilia Causes are: Infection (bacterial) Inflammatory conditions Neoplasia Metabolic conditions Hemorrhage, Hemolysis MPD 3

Drugs (e. g. corticosteroid therapy (inhibits margination): lithium, tetracycline) Treatment with myeloid growth factors (e. g. G - CSF) Rare inherited disorders Asplenia 4

Neutropenia The lower limit of the normal neutrophil count is 2. 5 *10 9 /L except in black people and in the Middle East where 1. 5 *10 9 /L is normal. When the absolute neutrophil level falls below 0. 5 *10 9 /L the patient is likely to have recurrent infections 5

Neutropenia Causes are: Congenital (Kostmann’s syndrome) Cyclical neutropenia Marrow aplasia Megaloblastic anemia Infections (typhoid, miliary TB, viral hepatitis) Drugs Irradiation Immune disorders Hypersplenism 6

Eosinophilia Causes are: Parasitic infection Skin disorders Allergic conditions Neoplasia Myeloproliferative disorders Hypereosinophilic syndrome 7

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Basophilia: An increase in blood basophils above 0. 1 *10 9 /L is uncommon. The usual cause is a myeloproliferative disorder such as chronic myeloid leukemia or polycythaemia vera. Reactive basophil increases are sometimes seen in myxoedema, during smallpox or chickenpox infection and in ulcerative colitis. 9

Monocytosis: A rise in blood monocyte count above 0. 8 *10 9 /L is infrequent. Causes are: Chronic bacterial infections: tuberculosis, brucellosis, bacterial endocarditis, typhoid Connective tissue diseases – SLE, temporal arteritis, rheumatoid arthritis Protozoan infections Chronic neutropenia Hodgkin lymphoma, AML and other malignancies Chronic myelomonocytic leukemia 10

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Lymphocytosis Causes are: Viral infections (infectious mononeuclosis, infectious lymphocytosis, CMV …etc). Bacterial infections: (Pertussis, occasionally healing TB, Brucellosis, Secondary and Congenital Syphilis, Typhoid fever, Diphtheria) Protozoal infections: Toxoplasmosis Lymphoproliferative Disorders: CLL, Lymphoma 12

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