Short-Term Exercise and Immune Function
Ronald R. Watson, Marianne Eisinger in Exercise and Disease, 2020
This chapter focuses on the most commonly used measures of immune function and discuss the immune response to short-term exercise which is presented as bouts of exercise that are 60 min or less in duration. Unlike the general processes of innate immunity, the processes of acquired immunity are directed at specific disease organisms. Much of the human body’s ability to resist almost all types of invading organisms or toxins is dependent upon acquired immunity. Short-term exercise results in an increase in the number of lymphocytes and neutrophils in peripheral blood sampled immediately following exercise. In blood samples taken immediately after exercise, earlier investigators attributed the lymphocytosis to increased numbers of both T-cells and B-cells. If blood samples are taken soon after exercise and results are expressed in relative terms, the literature suggests that a single bout of short-term exercise is accompanied by some transient degree of suppressed lymphocyte proliferation in response to a nonspecific mitogen.
Salmonella typhi
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
A 53-year-old lady returned from a visit to Lahore complaining of feeling generally unwell. She had a temperature and a cough. She attended a clinic where she was seen by a doctor who confirmed that she had a temperature of 38°C and he noticed a rash on the upper chest. She was admitted to hosptial for investigation, which included a thick and thin film for malaria, a full blood count, urea and electrolytes, a chest X-ray, and blood cultures. The malaria investigation was negative, the chest X-ray showed patchy basal consolidation, the full blood count revealed a relative lymphocytosis and gram-negative bacilli were seen in the blood culture ( Figure 1 ). A provisional diagnosis of enteric fever was made and she was started on appropriate antibiotics. The diagnosis was confirmed by isolation of Salmonella typhi from the blood cultures.
Adrenal emergencies: Adrenal crisis
Nadia Barghouthi, Jessica Perini in Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
An adrenal crisis is a potentially life-threatening event for a patient with adrenal insufficiency. Triggers for adrenal crisis during pregnancy may be inappropriately considered part of a normal adaptation to gestation and thus managed appropriately. Laboratory assessment should never delay administration of glucocorticoids in suspected adrenal crisis. Patient education regarding adrenal crisis prevention with emphasis placed on stress doses should be provided in writing to each patient with adrenal insufficiency. The estimated prevalence of adrenal insufficiency in pregnant women is 5.5/100,000, with rates steadily rising. Cortisol suppresses inflammatory cytokines; the absence of this inhibition leads to malaise, anorexia, and fever. The lack of inhibition of inflammatory cytokines also leads to altered immune-cell populations with eosinophilia, neutropenia, and lymphocytosis seen in glucocorticoid-deficient patients. Delivery itself may precipitate a crisis if the patient does not receive stress dose glucocorticoids prior to and throughout delivery.
Characterizing the kinetics of lymphocytosis in patients with chronic lymphocytic leukemia treated with single-agent ibrutinib
Published in Leukemia & Lymphoma, 2019
Jacqueline C. Barrientos, Jan A. Burger, John C. Byrd, Peter Hillmen, Cathy Zhou, Joi Ninomoto, Danelle F. James, Thomas J. Kipps
Increased absolute lymphocyte count (ALC) is a key feature of chronic lymphocytic leukemia (CLL) but is also observed during treatment with B-cell receptor pathway inhibitors including ibrutinib, a first-in-class inhibitor of Bruton’s tyrosine kinase. In patients with CLL treated with single-agent ibrutinib in two multicenter, open-label, randomized, phase 3 studies (RESONATE-2, NCT01722487; RESONATE, NCT01578707), lymphocytosis was observed in 77 of 136 (57%) patients treated in first-line and 133 of 195 (69%) relapsed/refractory patients. On treatment, lymphocytosis resolved in 95% of patients in the first-line and 94% in the relapsed/refractory setting. The median duration of lymphocytosis was 12 and 14 weeks in the first-line and relapsed/refractory settings, respectively. Lymphocytosis is a common and predictable pharmacodynamic effect of ibrutinib treatment, and in the absence of other signs of progression, does not represent disease progression. Lymphocytosis resolves in the majority of patients and does not require interruption or discontinuation of ibrutinib therapy.
A 20 Year Clinical and Laboratory Study of Familial B-Chronic Lymphocytic Leukemia in a Single Kindred
Published in Leukemia & Lymphoma, 1991
Neil E. Caporaso, Jean Whitehouse, Pablo Bertin, Chris Amos, Nicholas Papadopoulos, Jacqueline Muller, Jacqueline Whang-peng, Margaret A. Tucker, Thomas A. Fleisher, Gerald E. Marti
Four siblings and a parent in a single kindred had documented blood and marrow lymphocytosis during the past 18 to 20 years consistent with chronic lymphocytic leukemia (CLL). Of the four siblings, one developed a spontaneous remission; one died secondary to subepiglotitis with sepsis; one died with prolymphocytoid transformation and one remains alive with splenomegalic CLL. Lymphadenopathy and splenomegaly were variable as was the clinical response to chemotherapy. Bone marrow morphology was initially nodular but progessed to diffuse patterns in both deceased siblings. Blood lymphocyte morphology was extremely variable as were cell doubling times and cytogenetic studies. ABO and HLA typing revealed no evidence of linkage. Immunophenotypic analysis of the B lymphocytes demonstrated a CD19 +, CD20-, CD5 +, Leu8-, Kappa + and a CD19 +, CD20 +, CD5 +, Leu8 +, Kappa + monoclonal lymphocytosis in two affected members. An unaffected sibling showed a CD4 lymphocytosis. VHV and VHII gene sequences were previously described in this kindred (PNAS 84: 8563, '87). We speculate that a CD5 B cell and CD4 T cell lymphocytosis may arise early in this disease followed by the development of a pleomorphic, monoclonal lymphocytosis. The subsequent oligomorphic, monoclonal lymphocytosis shows genotypic, immunophenotypic and some morphological heterogeneity consistent with ongoing differentiation. The longitudinal investigation of familial CLL offers a unique opportunity to study the sequence of events related to the natural history of B-CLL.
Normal and clinical haematology of captive cranes (gruiformes)
Published in Avian Pathology, 1983
Christine Hawkey, J.H. Samour, D.G. Ashton, M.G. Hart, R.N. Cindery, J.M. Ffinch, D.M. Jones
Summary Fall blood counts on 56 clinically normal cranes of nine different species have provided reference values for the interpretation of haematological changes in 13 cranes presenting with abnormal clinical signs. Hypochromic anaemia, heterophilia and lymphocytosis were found in birds with probable Mycobacterium avium infection and heterophilia and lymphocytosis in birds with bumblefoot, arthritis, nephrosis and cardiac myo‐pathy. In several of the cases with heterophilia and lymphocytosis the fibrinogen level was also raised. A senile bird with thickened heart valves showed macrocytosis. The potential diagnostic value of clinical haematology in cranes is discussed.
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