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Manual Leukocyte Formula

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Types of Leukocytes and Their Functions

Neutrophils (NEU):

  • Comprise 55–70% of total leukocytes.
  • Serve as the first line of defense against foreign organisms.
  • Release chemical enzymes to destroy bacteria and fungi.

Lymphocytes (LYM):

  • Produced in the bone marrow and found in lymphatic tissue.
  • Two main types:
    • B-cells: Stay in the bone marrow where they are produced.
    • T-cells: Migrate to the thymus, then distribute to lymph nodes, spleen, tonsils, and intestines.
  • When foreign organisms invade, lymphocytes release lymphokines to stimulate immune cells to attack.

Monocytes and Macrophages (MON):

  • Make up about 8% of total leukocytes.
  • Produced in the bone marrow, enter the bloodstream, and reach tissues where they transform into macrophages.
  • Destroy bacteria and remove dead cells from tissues.

Eosinophils (EOS):

  • Destroy parasites and manage inflammation caused by allergic reactions.

Basophils:

  • The least numerous leukocytes in the body.
  • Responsible for producing immunoglobulin E antibodies.
  • Increase blood flow, combat parasitic infections, and play a role in identifying and destroying early-stage cancer cells.

Clinical Insights

  1. Normal Cells in Peripheral Blood Smears:

    • The above types of leukocytes are typically observed in healthy blood samples.

  2. Atypical Cells:

    • In certain conditions, atypical cells may appear, such as blasts, which are indicative of acute leukemia.
    • The presence and morphology of these cells should be documented and analyzed.

  3. Morphological Changes:

    • Beyond counting, manual microscopy identifies changes in leukocyte morphology, aiding in diagnosing infections, immune disorders, or hematological diseases.

 

  • Do not consume alcohol within 24 hours before the test.
  • Children under 1 year old should refrain from eating 30–40 minutes prior to the test.
  • Avoid food intake for 2–3 hours before the test; you may drink plain, non-carbonated water.
  • Avoid physical and emotional stress for 30 minutes before the test.
  • Do not smoke within 30 minutes before the test.
  • Determine the number and types of leukocytes and their ratios, as well as assess their morphological characteristics.
  • Used in cases of suspected infectious diseases and bone marrow pathologies.
  • Recommended if blood analysis from a hematological analyzer shows leukocyte counts outside reference values.
  • Neutrophilia (Increased Neutrophils): May occur in acute bacterial infections, poisoning, and myeloproliferative diseases.
  • Neutropenia: Can result from severe infections, sepsis, toxic effects on bone marrow (cytostatics, ionizing radiation, myelotoxic drugs), aplastic anemia, or congenital conditions (e.g., Kostmann’s neutropenia, cyclic neutropenia).
  • Eosinophilia: Common causes include allergic diseases, parasitic infections, and myeloproliferative disorders.
  • Basophilia (Increased Basophils): May indicate allergic reactions or myeloproliferative diseases.
  • Absolute Lymphocytosis: Found in infectious mononucleosis, viral infections (e.g., cytomegalovirus), and chronic lymphocytic leukemia.
  • Lymphopenia: Can be caused by prolonged use of glucocorticosteroids, severe viral diseases, congenital or acquired immunodeficiencies, and malignant tumors.
  • Monocytosis: Possible in infections, granulomatous diseases (e.g., tuberculosis, brucellosis, sarcoidosis), hematologic malignancies, and systemic connective tissue diseases.

    About Leukocyte Types

  • Neutrophils (NEU):

    • Comprise 55–70% of leukocytes.
    • Act as the first responders to foreign organisms, releasing enzymes to destroy bacteria and fungi.

  • Lymphocytes (LYM):

    • Produced in the bone marrow and distributed to lymphatic tissues (e.g., thymus, spleen, lymph nodes).
    • Include B-cells (stay in the bone marrow) and T-cells (mature in the thymus).
    • Release lymphokines to stimulate other immune cells to attack foreign organisms.

  • Monocytes (MON):

    • Make up about 8% of leukocytes.
    • Produced in the bone marrow and transform into macrophages in tissues, where they attack bacteria and remove dead cells.

  • Eosinophils (EOS):

    • Destroy parasites and manage inflammation caused by allergic reactions.

  • Basophils:

    • Least numerous type of leukocytes.
    • Produce immunoglobulin E (IgE) and play a role in combating parasitic infections and early cancer detection.

      Indications

    • Determine the number and types of leukocytes and their ratios, as well as assess their morphological characteristics.
    • Used in cases of suspected infectious diseases and bone marrow pathologies.
    • Recommended if blood analysis from a hematological analyzer shows leukocyte counts outside reference values.
  • Neutrophilia (Increased Neutrophils): May occur in acute bacterial infections, poisoning, and myeloproliferative diseases.
  • Neutropenia: Can result from severe infections, sepsis, toxic effects on bone marrow (cytostatics, ionizing radiation, myelotoxic drugs), aplastic anemia, or congenital conditions (e.g., Kostmann’s neutropenia, cyclic neutropenia).
  • Eosinophilia: Common causes include allergic diseases, parasitic infections, and myeloproliferative disorders.
  • Basophilia (Increased Basophils): May indicate allergic reactions or myeloproliferative diseases.
  • Absolute Lymphocytosis: Found in infectious mononucleosis, viral infections (e.g., cytomegalovirus), and chronic lymphocytic leukemia.
  • Lymphopenia: Can be caused by prolonged use of glucocorticosteroids, severe viral diseases, congenital or acquired immunodeficiencies, and malignant tumors.
  • Monocytosis: Possible in infections, granulomatous diseases (e.g., tuberculosis, brucellosis, sarcoidosis), hematologic malignancies, and systemic connective tissue diseases.

  • About Leukocyte Types

  • Neutrophils (NEU):

    • Comprise 55–70% of leukocytes.
    • Act as the first responders to foreign organisms, releasing enzymes to destroy bacteria and fungi.

  • Lymphocytes (LYM):

    • Produced in the bone marrow and distributed to lymphatic tissues (e.g., thymus, spleen, lymph nodes).
    • Include B-cells (stay in the bone marrow) and T-cells (mature in the thymus).
    • Release lymphokines to stimulate other immune cells to attack foreign organisms.

  • Monocytes (MON):

    • Make up about 8% of leukocytes.
    • Produced in the bone marrow and transform into macrophages in tissues, where they attack bacteria and remove dead cells.

  • Eosinophils (EOS):

    • Destroy parasites and manage inflammation caused by allergic reactions.

  • Basophils:

    • Least numerous type of leukocytes.
    • Produce immunoglobulin E (IgE) and play a role in combating parasitic infections and early cancer detection.

  • Diagnostic Insights

  • In normal conditions, the types of leukocytes mentioned above are observed in peripheral blood smears.
  • In certain diseases, atypical cells such as blasts (indicative of acute leukemia) may appear. The presence and morphology of atypical cells should be noted and analyzed.
  • Manual microscopy not only counts cells but also detects morphological changes, providing crucial diagnostic information.