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CASE STUDY 1 History and Physical Examination This family had a son who had died at of overwhelming bacterial infection. When their newborn daughter began developing recurrent infections, she was age 2 weeks because immediately taken to a pediatrician. Laboratory Data Hemoglobin and hematocrit-within normal range Total WBC count-62.0 x 10%/L Absolute leukocyte counts-above normal for each leukocyte type Leukocyte differential-neutrophils 76%, lymphocytes 22%, cosinophils 2% Flow cell cytometry T lymphocytes normal proportions of CD4+ and CD8+ cells B lymphocytes (XA19+) elevated Natural killer (NK) cells-elevated CD15+ lymphocytes-absent Serum Ig fractions within reference ranges Treatment The infant was given busulfan cyclophosphamide and antithymocyte serum for 10 days. She received mature T lymphocyte-depleted bone marrow transplanted from her mother. This was followed by a short period of immuno- suppressive therapy. She recovered from the procedures and did well clinically.

CASE STUDY 1 History and Physical Examination This family had a son who had died at of overwhelming bacterial infection. When their newborn daughter began developing recurrent infections, she was age 2 weeks because immediately taken to a pediatrician. Laboratory Data Hemoglobin and hematocrit-within normal range Total WBC count-62.0 x 10%/L Absolute leukocyte counts-above normal for each leukocyte type Leukocyte differential-neutrophils 76%, lymphocytes 22%, cosinophils 2% Flow cell cytometry T lymphocytes normal proportions of CD4+ and CD8+ cells B lymphocytes (XA19+) elevated Natural killer (NK) cells-elevated CD15+ lymphocytes-absent Serum Ig fractions within reference ranges Treatment The infant was given busulfan cyclophosphamide and antithymocyte serum for 10 days. She received mature T lymphocyte-depleted bone marrow transplanted from her mother. This was followed by a short period of immuno- suppressive therapy. She recovered from the procedures and did well clinically.

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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CASE STUDY 1 2222 History and Physical Examination This family had a son who had died at age 2 weeks because of overwhelming bacterial infection. When their newborn daughter began developing recurrent infections, she was immediately taken to a pediatrician. Laboratory Data Hemoglobin and hematocrit-within normal range Total WBC count-62.0 x 10°/L Absolute leukocyte counts-above normal for each leukocyte type Leukocyte differential-neutrophils 76%, lymphocytes 22%, cosinophils 2% Flow cell cytometry T lymphocytes normal proportions of CD4+ and CD8+ cells B lymphocytes (XA19+) elevated Natural killer (NK) cells-elevated CD15+ lymphocytes-absent Serum Ig fractions within reference ranges Treatment The infant was given busulfan cyclophosphamide and antithymocyte serum for 10 days. She received mature T lymphocyte-depleted bone marrow transplanted from her mother. This was followed by a short period of immuno- suppressive therapy. She recovered from the procedures and did well clinically. Questions 1. What significant finding in flow cytometry sug- gests an immune deficiency? a. Elevated B-lymphocytes (CD19+) count. b. Normal CD4+ and CD8+ lymphocyte counts c. Elevated NK cell count d. Absence of CD15+ cells What does the patient's family history suggest? a. Acute leukemia b. Immune antibody dysfunction c. Genetic leukocyte disorder d. Hereditary anemia See Appendix A for the answers to these questions. Critical Thinking Group Discussion Questions 1. What laboratory test is of the greatest diagnos- tic value in diagnosing this patient? 2. What value in the reported flow cytometry results is diagnostic? 3. Can leukocyte adhesion deficiency be misdiagnosed?
Transcribed Image Text:CASE STUDY 1 2222 History and Physical Examination This family had a son who had died at age 2 weeks because of overwhelming bacterial infection. When their newborn daughter began developing recurrent infections, she was immediately taken to a pediatrician. Laboratory Data Hemoglobin and hematocrit-within normal range Total WBC count-62.0 x 10°/L Absolute leukocyte counts-above normal for each leukocyte type Leukocyte differential-neutrophils 76%, lymphocytes 22%, cosinophils 2% Flow cell cytometry T lymphocytes normal proportions of CD4+ and CD8+ cells B lymphocytes (XA19+) elevated Natural killer (NK) cells-elevated CD15+ lymphocytes-absent Serum Ig fractions within reference ranges Treatment The infant was given busulfan cyclophosphamide and antithymocyte serum for 10 days. She received mature T lymphocyte-depleted bone marrow transplanted from her mother. This was followed by a short period of immuno- suppressive therapy. She recovered from the procedures and did well clinically. Questions 1. What significant finding in flow cytometry sug- gests an immune deficiency? a. Elevated B-lymphocytes (CD19+) count. b. Normal CD4+ and CD8+ lymphocyte counts c. Elevated NK cell count d. Absence of CD15+ cells What does the patient's family history suggest? a. Acute leukemia b. Immune antibody dysfunction c. Genetic leukocyte disorder d. Hereditary anemia See Appendix A for the answers to these questions. Critical Thinking Group Discussion Questions 1. What laboratory test is of the greatest diagnos- tic value in diagnosing this patient? 2. What value in the reported flow cytometry results is diagnostic? 3. Can leukocyte adhesion deficiency be misdiagnosed?
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