백혈구 구조 , 기능 및 백혈구질환

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

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

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

4. 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

5. 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

6. 중성구 살균 기능 - 관여물질 Adhesion Cascade

7. Phagocytosis and Killing

8. 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.

9. 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

10. 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

11. 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,

12. 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

13. 과립구의 후천성이상 • Toxic granules& vacuoles • Dohle body • Hypersegmentation & • Macrocytic neutrophil

14. 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

15. 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