This document discusses qualitative defects of granular white blood cells that can result in morphological or functional changes. These defects are either inherited or acquired. Some specific acquired disorders discussed include hyposegmentation, hypersegmentation, toxic changes in neutrophils, May-Hegglin anomaly, Alder's anomaly, Chediak-Higashi syndrome, and myeloperoxidase deficiency. The key changes described for each condition include abnormalities in neutrophil nuclear morphology or granules that can impact the cells' ability to fight infection.

1. Developed by
Dr.Abdulrazzaq Othman Alagbare-MD-MCP-
Hematology Lecturer
Qualitative defects of granular
white cells

2. Qualitative defects of granular white cells
May be on
 Morphologic changes
 Functional changes
These changes are classified as
either
1. Inherited
2. Acquired. (greater seen)
Qualitative changes of the white cell take place
either in the cytoplasm or the nucleus

3. Acquired disorders in Neutrophils
Hypo segmentation
Nuclear Abnormalities
Pelger-Huet anomaly
benign congenital
abnormality
What changes in the
nucleus?
Bilobed and occasional
unsegmented neutrophils
don’t affect the cells

4. 2-Hypersegmentation
Defined as a
segmented neutrophilic
nucleus having more
than five lobes, (
indication of
Megaloblastic anemia)

5. Toxic Changes in Granular White Cells
Neutrophils with
1. Toxic granulation,
2. Toxic vacuolization
3. Presence of Dohle bodies
Döhle Bodies
Toxic granulation and toxic vacuolization

6. 3-May-Hegglin anomaly
1. Neutrophils contain basophilic inclusions of RNA
2. leucopenia
3. Thrombocytopenia and giant platelet are frequent

7. 4-Alder’s anomaly
This anomaly occurs in
1.Granulocytes (Neutrophils)
2.Monocytes
3.Lymphocytes
They contain granules
which stain purple with
Romanowsky stain
Neutrophils with granules Lymphocyte and Monocyte with granules

8. Alder’s anomaly
Neutrophils with granules

9. 5-Chediak-Higashi syndrome
This anomaly occurs in
1.Granulocytes (Neutrophils)
2.Monocytes
3.Lymphocytes
4.Platelets
They contain
Giant granules
Neutrophils in Chediak-Higashi
syndrome
Loss the Chemotaxis and
phagocytosis ability
Platelets lack dense granules and platelet function is abnormal

10. 6-Myeloperoxidase deficiency
(MPO)
MPO exist normally in
1-Neutrophils
2-Monocytes
What is MPO deficiency?
Inherited
Autosomal recessive
How present the deficiency?
Absence of the MPO
Result of this absence in the phagocyte
cells cannot kill the foreign substances
which engulfed
Negative MPO
Positive MPO