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Monocytosis and Monocytopenia
Monocytosis
It is a condition in which absolute monocyte count is more than 800/cmm in adults.
Causes
- Myeloid neoplasms
- MDS (25% patients have monocytosis)
- Acute monocytic leukemia.
- Acute myelomonocytic leukemia.
- Chronic myelomonocytic leukemia.
- Juvenile myelomonocytic leukemia.
- CML (m BCR-positive type)
- Polycythemia vera.
- Lymphoid neoplasms- NHL, HD, myeloma, macroglobulinemia, T cell lymphoma
- Inflammatory and immune disorders.
- RA
- SLE
- Temporal arteritis
- Kawasaki disease
- Myositis
- Polyarthritis nodosa
- Sarcoidosis
- Inflammatory bowel disease
- Immune thrombocytopenia
- Infections
- Mycobacterial infections
- Subacute bacterial endocarditis
- Brucellosis
- Dengue hemorrhagic fever
- Resolution phase of acute bacterial infections
- Syphilis
- CMV infection
- Influenza
- Varicella zoster virus
- Rickettsia.
- Protozoal infections (Ex: Leishmaniosis)
- Chronic fungal infections
- GI disorders.
- Alcoholic liver disease
- Inflammatory bowel disease.
- Sprue
- Miscellaneous
- Parturition
- Glucocorticoid administration
- Depression
- Chronic stress
- Thermal injury
- Marathon running
- Chronic neutropenia.
- Drug induced neutropenia.
- WiskotAdlrich syndrome
- Immune hemolytic anemia.
- Sickle cell anemia
- Post splenectomy state
- Recovery from myelosuppression
- Non hematopoietic malignancies
- Exogenous cytokine administration: G-CSF, IL10.
- Myocardial infarction/ Cardiac bypass surgery
- Lipid storage disorders
Monocytopenia
Causes:
- Aplastic anemia
- Myelodysplastic syndrome
- Hairy cell leukemia
- Glucocorticoid therapy
- Monocytopenia- Mycobacterium Avium Complex syndrome- Autosomal dominant/ sporadic mutation of GATA, Bone marrow is hypocellular with reticulin fibrosis, multilineage dysplasia is seen, Cytogenetics: del 7 and trisomy 8. Treatment- HSCT
- Drugs: Chemotherapy, interferon alpha
- Radiation therapy
- Overwhelming sepsis
- Stress
Clinical manifestations:
- Increased risk of infection with mycobacteria, listeria, brucella, trypanosomes and other granuloma producing organisms
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