White Blood Cell Disorders

drg. Gita Dwi Jiwanda Sovira, M.Kes

Leukocytes
 Divided into two categories: granulocytes and agranulocytes.
 A. Granulocytes, have granules in their cytoplasm and include neutrophils,
eosinophils, and basophils.
 B. Agranulocytes, do not have granules in their cytoplasm and include
monocytes and lymphocytes.
 Dibagi menjadi dua kategori: granulosit dan agranulosit.
 A. Granulosit, memiliki butiran dalam sitoplasma dan termasuk neutrofil,
eosinofil, dan basofil.
 B. Agranulosit, tidak memiliki butiran dalam sitoplasma dan termasuk
monosit dan limfosit
Leukocytes
 Neutrophils (55%)  important for destroying bacteria, viruses, and toxins in the blood.
 Eosinophils (3%)  rid of parasitic infections, control inflammation and allergic reactions
 Basophils (<1%)  release histamine and heparin, which promote inflammation.
 Monocytes (8%)  destroying bacteria, viruses,and toxins
 Lymphocytes (33%)  provide immunity for the body
 Neutrofil (55%)  penting untuk menghancurkan bakteri, virus, dan racun dalam darah.
 Eosinofil (3%)  menghilangkan infeksi parasit, mengendalikan peradangan dan reaksi alergi
 Basofil (<1%)  melepaskan histamin dan heparin, yang memicu peradangan.
 Monosit (8%)  menghancurkan bakteri, virus, dan racun
 Limfosit (33%)  memberikan kekebalan bagi tubuh
 White blood cell  5000 - 10,000 cells.
 If above normal  leukocytosis, results from bacterial infections.
 If below normal  leukopenia, caused by some viral infections and
various other conditions.
Patology of White Blood Cell
1. Leukemia
 A condition in which the bone marrow produces a large number of white blood cells.
  prevent from carrying out their defensive functions.
 Causes : mutations in white blood cells, chemotherapy, genetic factors and exposure to agents that cause changes
in the white blood cells.
 Signs and symptoms : fatigue, difficulty breathing during physical activity, an enlarged liver or spleen, swollen
lymph nodes, abnormal bruising, cuts that heal slowly, frequent infections, nosebleeds, bleeding gums, chronic
fever, unexplained weight loss, and excessive sweating.
 Kondisi saat sumsum tulang menghasilkan banyak sel darah putih.
  mencegah menjalankan fungsi pertahanannya.
 Penyebab: mutasi pada sel darah putih, kemoterapi, faktor genetik dan paparan agen yang menyebabkan
perubahan pada sel darah putih.
 Tanda dan gejala: kelelahan, kesulitan bernapas saat melakukan aktivitas fisik, pembesaran hati atau limpa,
pembengkakan kelenjar getah bening, memar yang tidak normal, luka yang sembuh perlahan, sering infeksi,
mimisan, gusi berdarah, demam kronis, penurunan berat badan yang tidak dapat dijelaskan, dan keringat berlebih.
 Treatment : chemotherapy, bone marrow transplant, medications to
strengthen the immune system, a stem cell transplant, radiation therapy, and
antibodies to destroy mutated white blood cells.
 kemoterapi, transplantasi sumsum tulang, obat-obatan untuk memperkuat
sistem kekebalan, transplantasi sel induk, terapi radiasi, dan antibodi untuk
menghancurkan sel darah putih yang bermutasi.
2. Leukopenia
 The bone marrow produces very few white blood cells, leaving the body unprotected against many
bacteria and other agents that might invade the tissues.
 Normally, the human body lives in symbiosis with many bacteria.
 The mouth almost always contains various spirochetal, pneumococcal, and streptococcal bacteria, and
these same bacteria are present to a lesser extent in the entire respiratory tract.
 The distal gastrointestinal tract is especially loaded with colon bacilli.

 Sumsum tulang menghasilkan sangat sedikit sel darah putih, membuat tubuh tidak terlindungi dari
banyak bakteri dan agen lain yang mungkin menyerang jaringan.
 Biasanya, tubuh manusia hidup bersimbiosis dengan banyak bakteri.
 Mulut hampir selalu mengandung berbagai bakteri spirochetal, pneumokokus, dan streptokokus, dan
bakteri yang sama ini hadir dalam jumlah yang lebih sedikit di seluruh saluran pernapasan.
 Saluran gastrointestinal bagian distal penuh dengan basil usus besar.
 Within 2 days after the bone marrow stops producing white blood cells,
ulcers may appear in the mouth and colon, or the person might develop
some form of sever respiratory infection. Bacteria from the ulcers rapidly
invade surrounding tissues and the blood.
 Without treatment, death often ensues in less than a week after acute total
leukopenia begins.
 Tanpa pengobatan, kematian sering terjadi dalam waktu kurang dari
seminggu setelah leukopenia total akut dimulai
 Cause
 Irradiation of the body by x-rays or gamma rays, exposure to drugs and
chemicals that contain benzene of anthracene nuclei, chloramphenicol (an
antibiotic) thiouracil (used to treat thyrotoxicosis), and even variou
barbiturate hypnotics.
1. NON-NEOPLASTIC DISORDERS OF
WHITE CELLS
 1A. Leukopenia
 Neutropenia/Agranulocytosis : reduction in the number of granulocytes in
blood
Clinical Features : malaise, chills, and fever, weakness and
fatigability. Ulcerating, necrotizing lesions of the gingiva, floor of
the mouth, buccal mucosa, pharynx, or other sites within the oral
cavity (agranulocytic angina).
Gambaran Klinis: malaise, menggigil, dan demam, kelemahan dan
kelelahan. Ulserasi, lesi nekrotikans pada gingiva, dasar mulut,
mukosa bukal, faring, atau tempat lain di dalam rongga mulut (angina
agranulositik).
 1B. Reactive Leukocytosis : An increase in the number of
white cells in the blood, caused by microbial and nonmicrobial
stimuli