Friday, 19 November 2010

MRCP revision battle 54.6: Leukoerythroblastic change

Leukoerythroblastic change is the term used to describe nucleated red cells and primative white cells in the peripheral blood.

Causes of leukoertythroblastic change can be split into 2 catagories:

1. Invasion of bone marrow space
  • metastatic carcinoma
  • leukaemia
  • myeloma
  • lymphoma
  • myelofibrosis
  • Gaucher's disease (covered in next battle)
2. Severe illness

Leukoerythroblastic change may be indicated by:
  • high leucocyte alkaline phosphatase
  • Dohle bodies = blue leucocyte inclusions in peripheral cytoplasm of neutrophils
  • left shift of neutrophils = younger neutrophils than normal -->less nuclei

As an aside, Dohle bodies are also seen in burns, infection and trauma.

Now for the final short skirmish, Gaucher's disease...