White cell differentiation

The basic aperture impedance method can produce three-part white cell differential counts. Impedance counters can distinguish three white cell types by size the LYMPHS, mid-range cells including MONOS and BASOS, and granulocytes including NEUTS and EOS. 

Glucose Lactic dehydrogenase (LDH) Phosphorus Potassium Serum glutamic-oxaloacetic transaminase (SGOT) Serum glutamic-pyruvic transaminase (SGPT) Sodium Total bilirubin Total cholesterol Total protein Triglycerides White cell differential count ... 

Biood dyscrasias Agranulocytosis, bone marrow depression, neutropenia, hypoplastic anemia and thrombocytopenia in patients receiving procainamide have been reported at a rate of approximately 0.5%. Fatalities have occurred (with approximately 20% to 25% mortality in reported cases of agranulocytosis). Perform complete blood counts including white cell, differential, and platelet counts at weekly intervals for the first 3 months of therapy, and periodically thereafter. Perform complete blood counts promptly if the patient develops any signs of infection (eg. 

Obtain complete pretreatment hematological testing as a baseline. Repeat these tests at monthly intervals during the first 2 months and, thereafter, obtain yearly or every-other-year CBC, white cell differential, and platelet count. 

C23. Cobbold, S., Hale, G., and Waldmann, H., Non-lineage, LFA-1 family, and leucocyte common antigens New and previously defined clusters. In Leukocyte Typing III White Cell Differentiation Antigens (A. J. McMichael, P. C. L. Beverley, S. Cobbolds, etal., eds.), pp. 788-804. Oxford University Press, Oxford, 1987. 

Zl. Zhou, L.-J., and Tedder, T. F., CD20 workshop panel report. In Leukocyte Typing V White Cell Differentiation Antigens (S. F. Schlossman, L. Boumsell, W. R. Gilks, et al. eds.), pp. 511-514. Oxford University Press, New York, 1995. 

Complete blood cell count with differential In cases of uveitis a complete blood cell coimt can help identify an underlying bacterial or viral etiology based on the white cell differential. Additionally, this test may assist in the detection of a white blood cell malignancy, such as leukemia or lymphoma. A complete blood cell count should also accompany an erythrocyte sedimentation rate (ESR) analysis, because the complete blood cell count identifies anemia that may affect the results of the ESR. 

Bench top devices are also available to perform complete blood counts (CBC) using analytical principles similar to those used in laboratory-based devices. In addition, single-use cartridge technology is being developed that will have the capability to offer full white cell differentiation. Immunoassay measurements are also now available in a compact device, for use in clinics and similar locations. The Innotrac Aio is an example of such a device and uses... 

CelHdentification White cell differentiation Erythrocyte count Hematocrit Hemoglobin Leukocyte count Platelet count Fibrinogen... 

Leucocyte Typing VI, et al. White Cell Differentiation Antigens. In Kishimoto T, Goyert S, Kikutani H, eds. Sixth International Workshop and Conference 1997. Kobe, Japan Garland Publishers 1997. 

H.P. Mansberg, A.M. Saunders, W. Groner, Hemalog-D white cell differential system, J. Histochem. Cytochem. 22 (1974) 711. 

A 52-year-old man was admitted to the hospital for abdominal surgery. He developed complications postoperatively and was intubated 6 days ago. The nurses note an increase in the amount and purulence of his sputum. Attempts yesterday and today to wean the patient off the ventilator have failed. He is sedated but does respond to commands. His temperature is 38.4°C, his blood pressure is 120/84 mm Hg, and his white blood cell (WBC) count is 14.2/mm3 with a cell differential of 76% neutrophils, 4% bands, 16% lymphocytes, and 4% monocytes. 

A reduction in total white blood cell counts to 60% of control values (p<0.05), but no changes in differential white cell counts or evidence of bone marrow damage, was found in rats intermittently exposed to 700 ppm 2-hexanone after 8 weeks during an 11-week study (Katz et al. 1980). These findings, although inconclusive, suggest that immunological effects may warrant some consideration in future assessments of the potential toxicity of inhalation exposure to 2-hexanone. 

Lead exposure Not a substitute for effective abatement of lead exposure. Neutropenia Mild to moderate neutropenia has been observed in some patients receiving succimer. While a causal relationship to succimer has not been definitely established, neutropenia has been reported with other drugs in the same chemical class. Obtain a complete blood count with white blood cell differential and direct platelet counts prior to and weekly during treatment. Withhold or discontinue therapy if the absolute neutrophil count (ANC) is below 1200/mcL and follow the patient closely to document recovery of the ANC to above 1500/mcL or to the patient s baseline neutrophil count. There is limited experience with reexposure in patients who have developed neutropenia. Therefore, rechallenge such patients only if the benefit of succimer therapy clearly outweighs the potential risk of another episode of... 

Monitor white and differential blood cell count, hemoglobin determination, and direct platelet count every 2 weeks for the first 6 months of penicillamine therapy and monthly thereafter. 

Monitoring Perform complete blood counts, including differential white cell count and liver function tests before starting sulfasalazine and every second week during the first 3 months of therapy. During the second 3 months, perform the same tests once monthly and, thereafter, once every 3 months and as clinically indicated. Also perform urinalysis and assess renal function periodically during treatment. 

The various organs of the immune system such as spleen, lymph nodes, thymus and bone marrow containing the cells involved in the various immune responses offer the possibility to harvest these cells and perform in vitro assays for evaluation of effects on the immune system. When part of an in vivo animal study this may indicate a direct toxic effect of pharmaceuticals, that is, immunosuppression (Table 18.2). So, it is feasible to obtain cell suspensions for further evaluation such as determination of cellular subsets of T and B leukocytes by fluorescent activated cell sorter analysis (FACS analysis), and determination of natural killer (NK) cell activity of the spleen cell population. An advantage of this approach is that it may lead to identification of a biomarker to be used in clinical studies. In addition, in vitro stimulation of spleen cells with mitogens activating specific subsets may indicate potential effects on the functionality of splenic cell populations. Concanavalin A (Con A) and phytohemagglutinin (PHA) activate Tcells, while lipopolysaccharide (LPS) activates primarily B cell populations. Blood is collected for total white blood cell (WBC) determination and blood cell differential count. In addition, serum can be obtained for determination of serum immunoglobulins. 

Reactions to antithyroid drugs have been described above. A minor rash can often be controlled by antihistamine therapy. Because the more severe reaction of agranulocytosis is often heralded by sore throat or high fever, patients receiving antithyroid drugs must be instructed to discontinue the drug and seek immediate medical attention if these symptoms develop. White cell and differential counts and a throat culture are indicated in such cases, followed by appropriate antibiotic therapy. 

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