WHITE BLOOD CELLS

WBC = leukocyte
o protect against infection
o function in innate and adaptive immune system
o made in bone marrow
o short lifespan, constantly made

TYPES OF WBC
1. MACROPHAGES
- innate immune system (1st responders)
- 3-7% of circulating WBCS
- monocytes mature into macrophages
 function: phagocytosis, create and secrete cytokines
 reside in spleen, other organs

2. LYMPHOCYTES (AGRANULOCYTES)
- adaptive immune system (specific antigens with memory; long-term immunity)
- 20-35% of circulating WBCS
- T cells and B cells
- mature in lymphoid tissue: lymph nodes, tonsils, adenoids, thymus gland, spleen
 B cells mature in bone marrow and develop into plasma cells in lymph
nodes
 plasma cells = antibody producing
 T cells mature in thymus gland  T helper (CD4) and cytotoxic T (CD8)

3. GRANULOCYTES
- function: digestive enzymes in granules that kill and catabolize debris during
phagocytosis
- neutrophils, basophils, eosinophils
o neutrophils: 60-70% of circulating WBCS
 1st responders
 antigens, corticosteroids, epinephrine release neutrophils
 polymorphonuclear leukocytes = mature neutrophils; lifespan 1-
2 days
 mature = segs // immature = bands
 immature neutrophils are released when circulating mature
neutrophils are exhausted
 bands indicates immune system is working hard to create
enough WBCs
 “shift to left” = high number of circulating bands
 o eosinophils
 1-6% of circulating WBCS
 released during parasitic and allergic reactions
 contain chemical mediators and enzymes: histamine
o basophils
 <1% of circulating WBCS
 released during infection, especially parasitic
 contain chemical mediators: histamine, prostaglandin, leukotrienes,
heparin
CREATION & MATURATION
o come from pluripotent stem cells in bone marrow during hematopoiesis
o stem cells = myeloid and lymphoid
 myeloid = granulocyte and monocyte
 lymphoid = lymphocyte
o blast cells = immature precursor cells for each cell line

HEMATOPOIESIS
all blood cells derived from pluripotent stem cell and can become any kind of blood cell
pluripotent stem cell  myeloid or lymphoid line 
myeloid  erythroblasts, myeloblasts, monoblasts, megakaryocytes  mature cells
erythroblasts  RBCs
myeloblasts and monoblasts  different types of WBCs
megakaryocytes  platelets
lymphoid  lymphoblasts  mature lymphocytes
PHAGOCYTOSIS
macrophage can move out of the capillary to engulf and capture an antigen with lysosomal
enzymes
INCREASES OR DECREASES IN WBC COUNT
causes for increase: infection, inflammation, extreme stress, neoplasms, bone marrow disorders
o leukocytosis = WBC > 11,000/µL
o neutrophils most common WBC affected (neutrophilia)
 neutrophilia = >7,700/µL in total WBC < 11,000/µL
 causes: infection, inflammation, malignancy, smoking, stress,
drugs (glucocorticoids, lithium, epinephrine)
 monocyte leukocytosis = > 800/µL
  monocytosis = increased monocytes + normal total WBC count
 causes:leukemia, bacterial infection, TB
 monocytopenia = low number of monocytes
o causes: steroids, malignancy
 eosinophilia = > 600/µL
 causes: allergy, parasitic infection, leukemia, toxins, drugs,
autoimmune diseases
 basophilic leukocytosis = high number of basophils
 causes: hypersensitivity/inflammatory reactions, parasitic
infection, hypothyroidism, UC, varicella virus
 basopenia = low number of basophils
 causes: malignancy
o leukemoid reaction = WBC > 50,000/µL from causes other than leukemia
o causes: hemorrhage, specific infections, splenic dysfunction, organ necrosis
o leukopenia: WBC < 4,000/µL
o causes: anything that causes WBC destruction
o increases infection risk, decreases signs of infection, diminishes healing ability
o neutrophils are most common WBC
 neutropenia = < 1,500/µL
 causes: deficient bone marrow function, WBC destruction, neutrophil shift
into tissues
 infections: bacterial, viral, parasitic
 drugs: chemotherapy, chloramphenicol, phenothiazines,
allopurinol, carbamazepine, phenylbutazone
 vitamin deficiences: megaloblastic anemia from B12 deficiency or
folate
 bone marrow disease: leukemia, myelodysplastic syndrome,
aplastic anemia, myelofibrosis, any cause of bone marrow
suppression
 radiation
 machinery: hemodialysis, cardiac bypass
 congenital disorders of bone marrow or neutrophil production or
from drugs stimulating immune system to attack cells: Kostmann
syndrome
 autoimmune destruction of neutrophils: Felty’s syndrome
 hypersplenism
 T lymphocytopenia = decreased T cells but normal levels for other
lymphocytes
 causes: HIV, inherited disorder, infection, radiation, chemotherapy
 B lymphocytopenia = too few B cells but normal levels for other
lymphocytes
 causes: immunosuppressants
 
NK lymphocytopenia = too few natural killer cells but normal levels of
other lymphocytes
o leukocytosis = increase in lymphocytes
o normally T cells decrease with age
 child: < 3,000/µL
 adult: < 1,500/µL
 elderly: < 1,400/µL
WBC DIFFERENTIAL NORMAL RANGES (4.1-10.9 x 10^3/µL)
o polymorphonuclear 35-80%
o immature polys 0-10%
o lymphocytes 20-50%
o monocytes 2-12%
o eosinophils 0-7%
o basophils 0-2%
LYMPHATIC SYSTEM
tonsils, cervical lymph nodes, entrance of thoracic duct into subclavian vein, thymus gland, right
lymphatic duct, axillary lymph nodes, thoracic duct, spleen, Peyer’s patches in intestinal wall,
inguinal lymph nodes, red bone marrow