Post on 12-Jul-2015
1. Leukopenia
a) Agranulocytosis
b) Cyclic neutropenia
c) Chedik – Higashi Syndrome
2. Leukocytosis
a) Neutrophilia
b) Eosinophilia
c) Basophilia
d) Lymphocytosis
e) Monocytosis
f) Infectious Mononucleosis
g) Leukemia
Leukopenia
- Abnormal reduction in no. WBC in
peripheral blood stream
- Mainly occur due to decrease count of
granulocyte’s
Causes of Leukopenia
a) Infections
b) Haemopoietic disorders
c) Chemical agents
d) Physical agents
e) Anaphylactoid shock
f) Diseases of unknown etiology /
congenital
Agranulocytosis
( granulocytopenia, neutropenia, maliganant
leukopenia )
- Decrease no. of granulocytes
- this is classified as
1. Primary granulocytosis-etiology is unknown
2. Secondary granulocytosis-cause is recognised
Etiology
- Ingestion of any one of considerable
variety of drugs and infections
- Kostmann syndrome allergic
phenomenon
- Idiosyncracy
Clinical Features
- Occur at any age, majority – adult
women, workers in hospitals
- Symptom : Fever , malaise ,prostration,
systemic infections.
- Seen in jaundice cases rapidly progress
hence death occur within a week.
Oral Manifestation
- Necrotizing ulceration of oral mucosa,
tonsils, hemorrhage occur
- Tooth extraction contraindicated
- Excess salivation
Necrotizing ulceration of gingiva
Histological features
- Lack of development of normal
granular leucocytes
- No PMN reaction with bacteria
- Necrosis begins from sulcus of gingiva
spread up to alveolar bone cause rapid
destruction
Immature neutrophils
Laboratory Findings
- WBC count < 2000 cells/cumm
- Almost absence of granulocytes
- RBC & platelet count are normal, anemia
present
- In bone marrow –
myleocytes, metamyleocytes &
promyleocytes absent
- Cell maturation -arrest
Treatment & prognosis
- No specific t/t
- Withdrawal of causative drug &
Administration of antibiotic drug to control
Infection have good prognosis
Cyclic Neutropenia
- Unusual form of agranulocytosis
characterized by a periodic or cyclic
diminution in circulating bone marrow
maturation arrest
- Etiology is unknown
- Idiophatic neutropenia associated with
severe persistent gingivitis
Clinical Features
- Occur at any age, majority – children
- Symptom : Fever , malaise , stomatitis,
lymphadenopathy, systemic infections.
Necrotizing
ulceration with
severe bone loss
Necrotic gingiva
Oral Manifestation
- Severe gingivitis, reversible stomatitis
- In children's, loss of supporting bone
around teeth
- Necrotizing ulceration of oral mucosa,
tonsils
Radiographic Features
- Mild to severe loss of superficial
alveolar bone
- In children's prepubertal periodontisis
Laboratory Findings
- Sign & symptoms in periodic function
at every 3 weeks
- Patient exhibit normal blood count
decrease neutrophils
Treatment & Prognosis- No specific T/T, splenectomy beneficial
- Patient may suffer this disease for
several years
Chediak – Higashi Syndrome
- It is autosomal recessive
immunodeficiency disorder
characterized by abnormal intracellular
protein transport
Clinical Features- Bleeding , often fatal in childhood due to
non-malignant lymphohistocytic
- Abnormal functioning of PMN involve
skin & RS
Oral Manifestation
- Severe gingivitis, ulceration, glossitis
- Periodontal breakdown, defective
leucocyte function
Most commonly seen
In Albinism patient
Laboratory Findings
- Giant abnormal granules in peripheral
circulating Leucocyte in marrow
- Dhole bodies & pancytopenia some
times present
Treatment & Prognosis- No specific treatment
- Often fatal death occur before child
reach age 10 years
Leukocytosis
- Abnormal increase in the no.of
circulating WBC
- pathological condition
- In this the transient peripheral
plasmocytosis occur which is not
commonly found
1) Neutrophilia : Acute infection, coronary
thrombosis, acute homorrhage, myleoid metaplasia
2) Eosinophilia : Allergic disorders, myleocytic
leukemia
3) Basophilia : C.M.L, Splenectomy
4) Lymphocytosis : Acute infection, congenital
syphilis, Lympholytic leukemia
5) Monocytosis : Bacterial infection, Lymphoma
,C.M.L
Infectious Mononucleosis
- Caused by EPESTIN BARR VIRUS
- Cha. By consisting
fever,pharyngitis,adenopathy
- This virus transmitted by intimate
contact with body secretion, hense
called as kissing Disease
Clinical features
-Epidemic form-fever,lymphadenopathy
-splenomegaly,tonsilitis,hepatitis
Oral manifestation
-no specific but sec.lesions occur,acute
gingivitis & stomatitis
-petechial hemorrages of soft palate near
junction-early manifetation sign
-palatine petechiae
Pinpoint petechial hemorrahages
Lab findings
- ESR is eleveted, WBC are commonly
increases
- Lymphocytosis->50%
Treatment
- Bed rest & adequate diet
Leukemia
- Defination: progressive overproduction
of WBC which usually appear in
circulating blood in an immature form
- It’s unco-ordinated considered as ‘ True
Malignant Neoplasm’
- Etiology: unknown
- But mostly as viral origin(EBV –
leukomogenic virus)
- It is classify as
1:lymphoid leukemia
2:myeloid leukemia
eg; acute myleoid leukemia
Acute Subacute Chronic
<6 months >=< 1 yr >1year
- Philadelphia chromosome-80-95% pt
with chronic myleoid leukemia
- Mongoloids h’ve 15-20 times greater
chance of acute form of leukemia
Clinical feature
Acute Chronic
Childs & young adult adults
weakness, swelled Lymph
nodes, petechiae
Patient have excellent
health
decrease megakaryocyte systemic organs enlarged,
decreased salivary
secretion, papules form,
osteomyelitis
Lab findings
Acute: B.T & C.T. increased
leukocyte count eleveted upto
1,00,000 cu/mm but its immature
Chronic: anemia & thrombocytopenia
WBC count eleveted upto 5,00,000
Cu/mm may form chronic dyscrasia
Oral manifestation
-In both chronic & acute condition oral
lession occur at 87% in monocytic leukemia,
23% lymphoid leukemia
- Primary seen
gingivitis,hemorrage,petechiae,ulceration
- severe cases,teeth almost hidden,bleed
Easily,necrosis
-Rapid loosening of teeth due to destruction
Of bone
Severe gingival
hyperplasia
Loosening of teeth
Hidden of teeth
Treatment
- Chemotherapeutic drugs, radiation
therapy & corticosteroid recomanded
- Lymphocytic leukemia most fatal