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GENERAL CONSIDERATIONS

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  • Initially, one should use appropriate normal neutrophil concentration values for certain ethnic groups in which neutrophil counts are significantly lower than persons of European ancestry (e.g., African ancestry, Yemeni Jewish ancestry).

  • In this classification, diseases resulting from neutrophil abnormalities in which the neutrophil is either the only cell type affected or is the dominant cell type affected are considered (Table 31–1).

  • Neutropenia or neutrophilia occurs as part of disorders that affect multiple blood cell lineages, (e.g., aplastic anemia [see Chap. 3], myelodysplastic syndrome [see Chap. 42], acute and chronic myelogenous leukemias [see Chaps. 46 and 47], chronic myeloproliferative diseases [see Chaps. 43, 44, and 48]).

  • A pathophysiologic classification of neutrophil disorders has proved elusive because:

    — The low concentration of blood neutrophils in neutropenic states makes measuring the circulatory kinetics of autologous cells technically difficult.

    — The two compartments of neutrophils in the blood, the random disappearance of neutrophils from the circulation, the extremely short circulation time of neutrophils (t1/2 = ~6 hours), the absence of techniques to measure the size of the tissue neutrophil compartment, and the disappearance of neutrophils by apoptosis or excretion from the tissue compartment make multicompartment kinetic analysis difficult.

  • Thus, the classification of neutrophil disorders is partly pathophysiologic and partly descriptive (see Table 31–1).

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Table Graphic Jump Location
TABLE 31–1CLASSIFICATION OF NEUTROPHIL DISORDERS

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