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