A. Neutrophilia (Leukocytosis)
- Acute Infection
- Chronic Inflammation (infectious or noninfectious)
- Glucocorticoid Therapy
- Stress Reaction
- Leukemia
- Smoking
- Lithium
- Asplenia, hyposplenism
- Congenital
- Chronic idiopathic neutrophilia
- Hereditary neutrophilia
- Leukocyte adhesion deficiency
- Familial cold urticaria
B. Neutropenia
- Increased Consumption
- Splenomegaly
- Felty's Syndrome
- Collagen Vascular Disease
- Drug induced autoantibodies
- Decreased Production
- Aplastic Anemia (autoimmune)
- Fanconi Anemia
- Viral Infection (especially Parvovirus B19)
- Radiation
- B12, Folate deficiency
- Marrow Infiltration: leukemia, tumor, myelofibrosis
- Cyclic Neutropenia: often in blacks, less frequent in hispanics
- Drugs [2]
- Chemotherapy: nearly all cytotoxic agents
- Antibiotics: chloramphenicol, sulfamethoxazole, amoxicillin, oxacillin, nafcillin
- Antithyroid Agents: propylthiouracil, carbimazole, methimazole
- Antiseizure Agents: carbamazepine, felbamate
- NSAIDs: aspirin, indomethacin, others
- Clozapine
- Ticlopidine
- Ganciclovir and valganciclovir
- Immunological: quinidine, heparin
C. Hypereosinophilia
- Neoplasm
- Allergy (drugs, other) and Asthma
- Addison's Disease
- Collagen Vascular Disease
- Parasitic Infection
- Mnemonic: "NAACP"
- Hypereosinophilic syndrome (precancerous syndrome)
D. Lymphocytosis
- Viral Infections
- Infectious mononucleosis (EBV)
- Cytomegaloviras (CMV)
- Hepatitis Viruses (HAV, HBV)
- Mumps, Rubella, Roseola
- Herpesviruses: simplex and zoster (varicella)
- Influenza
- Bacterial Infectious
- Pertussis
- Rickettsia
- Tuberculosis
- Syphilis
- Brucellosis
- Serum Sickness
- Drug Induced - uncommon
- Lymphocytic leukemias
E. Lymphopenia
- Severe combined immunodeficiency (various forms)
- X-linked due to mutation in gamma chain of interleukin 2 receptor
- JAK3 deficiency - mutation in signalling pathway
- Adenosine deaminase (ADA) deficiency
- Lymphocyte receptor gene rearrangement defects (RAG1, RAG2 gene mutations)
- Omenn's Syndrome (autoreactive type 2 T helper cells)
- Reticular Dysgenesis
- Acute bacterial and other infections
- HIV infection
- Glucocorticoids
- Chemotherapeutic agents
- Anti-thymocyte and OKT3 antibody therapies
- Other lymphocyte depleting therapies (CAMPATH 1H, Anti-CD20, others)
F. Monocytosis
- Primary Causes
- Cyclic neutropenia
- Congenital agranulocytosis
- Congenital disorders
- Secondary: recovery phase from neutropenia of any cause
- Malignant Disorders
- Chronic myelomonocytic leukemia
- Acute myeloid (M5) leukemia
- Chronic myeloid leukemia
- Monosomy 7 myeloproliferative disease
G. Thrombocythemia
- Iron Deficiency Anemia: probably the most common cause of increased platelet counts
- Inflammation
- Chronic infections
- Neoplasia
- Autoimmune: inflammatory bowel disease (IBD), rheumatoid arthritis, vasculitis
- Granulomatous Disease: sarcoidosis, Wegener's granulomatosis
- Infection (acute) - platelets may be thought of as "acute phase reactant"
- Neoplasm: any cancer, especially carcinomas and lymphomas
- Dehydration
- Hemolysis / Hemorrhage
- Non-functional spleen: splenectomy, splenic infarction, sickle cell disease
- Essential Thrombocythemia: Myeloproliferative Syndrome (platelets often >10e6/µL)
H. Thrombocytopenia
- Drugs: chemotherapy, heparin, chloramphenicol, Ticlopidine, Clozepine, H2-blockers
- Autoimmune
- Previously called idiopathic
- May follow viral infection
- Splenomegaly: liver failure, malignancy, infection
- Viral: follows infection. ? Autoimmune. Associated with CMV, HIV
- Isoimmune: in neonates, mother makes anti-platelet antibody
- Neoplastic: infiltration of bone marrow prevents platelet development
- Aplastic Anemia: pancytopenia; viral, idiopathic, autoimmune, chloramphenicol
- Thrombotic thrombocytopenic purpura (TTP): with hemolysis, fever, mental status changes
- Disseminated intravascular coagulopathy (DIC): consumptive coagulopathy
- HIV Related
- HELLP Syndrome: Follows pregnancy. Low platelets
- Hereditary Disorders [3]
I. Abnormal Red Blood Cell Counts
- Anemia
- Polycythemia
References
- Stock W and Hoffman R. 2000. Lancet. 355(9212):1351
- Andres E, Kurtz JE, Martin-Hunyadi C, et al. 2002. Am J Med. 112(6):462
- Lipton JM, Westra S, Haverty CE, et al. 2004. NEJM. 351(11):1120 (Case Record)