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WhitebloodcellWikipedia

Whitebloodcell
FromWikipedia,thefreeencyclopedia

Whitebloodcells(WBCs),alsocalledleukocytesorleucocytes,arethecellsoftheimmunesystemthatare
involvedinprotectingthebodyagainstbothinfectiousdiseaseandforeigninvaders.Allwhitebloodcellsare
producedandderivedfrommultipotentcellsinthebonemarrowknownashematopoieticstemcells.Leukocytes
arefoundthroughoutthebody,includingthebloodandlymphaticsystem.[1]

Whitebloodcell(WBC)

Allwhitebloodcellshavenuclei,whichdistinguishesthemfromtheotherbloodcells,theanucleatedredblood
cells(RBCs)andplatelets.Typesofwhitebloodcellscanbeclassifiedinstandardways.Twopairsofbroadest
categoriesclassifythemeitherbystructure(granulocytesoragranulocytes)orbycelldivisionlineage(myeloid
cellsorlymphoidcells).Thesebroadestcategoriescanbefurtherdividedintothefivemaintypes:neutrophils,
eosinophils,basophils,lymphocytes,andmonocytes.[2]Thesetypesaredistinguishedbytheirphysicaland
functionalcharacteristics.Monocytesandneutrophilsarephagocytic.Furthersubtypescanbeclassifiedfor
example,amonglymphocytes,thereareBcells,Tcells,andNKcells.
Thenumberofleukocytesinthebloodisoftenanindicatorofdisease,andthustheWBCcountisanimportant
subsetofthecompletebloodcount.Thenormalwhitecellcountisusuallybetween4109/Land11109/L.In
theUSthisisusuallyexpressedas4,000to11,000whitebloodcellspermicroliterofblood.[3]Theymakeup
approximately1%ofthetotalbloodvolumeinahealthyadult,[4]makingthemsubstantiallylessnumerousthan
theRBCsat40%to45%.However,this1%ofthebloodmakesalargedifferencetohealth,becauseimmunity
dependsonit.Anincreaseinthenumberofleukocytesovertheupperlimitsiscalledleukocytosis.Itisnormal
whenitispartofhealthyimmuneresponses,whichhappenfrequently.Itisoccasionallyabnormal,whenitis
neoplasticorautoimmuneinorigin.Adecreasebelowthelowerlimitiscalledleukopenia.Itweakensthe
immunesystem.

Ascanningelectronmicroscopeimageofnormal
circulatinghumanblood.Inadditiontothe
irregularlyshapedleukocytes,bothredbloodcells
andmanysmalldiscshapedplateletsarevisible.
Identifiers

Contents
1 Etymology
2 Types
2.1 Overview
2.2 Neutrophil
2.3 Eosinophil
2.4 Basophil
2.5 Lymphocyte
https://en.wikipedia.org/wiki/White_blood_cell

MeSH D007962(https://www.nlm.nih.gov/cgi/mes
h/2011/MB_cgi?mode=&term=Leukocytes)
TH

H2.00.04.1.02001(http://www.unifr.ch/ifa
a/Public/EntryPage/ViewTH/THh200.html)

FMA 62852(http://xiphoid.biostr.washington.ed
u/fma/fmabrowserhierarchy.html?fmaid=6
2852)
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3
4

5
6
7
8

2.5 Lymphocyte
2.6 Monocyte
Fixedleucocytes
Disorders
4.1 Leucopenias
4.1.1 Neutropenia
4.1.2 Lymphocytopenia
4.2 Proliferativedisorders
4.2.1 Neutrophilia
4.2.2 Eosinophilia
Countingandreferenceranges
Seealso
References
Externallinks

Anatomicalterminology
[editonWikidata]

Etymology
Thename"whitebloodcell"derivesfromthephysicalappearanceofabloodsampleaftercentrifugation.Whitecellsarefoundinthebuff,athin,typicallywhite
layerofnucleatedcellsbetweenthesedimentedredbloodcellsandthebloodplasma.Thescientifictermleukocytedirectlyreflectsitsdescription.Itisderived
fromtheGreekrootsleukmeaning"white"andcytmeaning"cell".Thebuffycoatmaysometimesbegreeniftherearelargeamountsofneutrophilsinthe
sample,duetothehemecontainingenzymemyeloperoxidasethattheyproduce.

Types
Overview
Allwhitebloodcellsarenucleated,whichdistinguishesthemfromtheanucleatedredbloodcellsandplatelets.Typesofleukocytescanbeclassifiedinstandard
ways.Twopairsofbroadestcategoriesclassifythemeitherbystructure(granulocytesoragranulocytes)orbycelllineage(myeloidcellsorlymphoidcells).These
broadestcategoriescanbefurtherdividedintothefivemaintypes:neutrophils,eosinophils,basophils,lymphocytes,andmonocytes.[2]Thesetypesare
distinguishedbytheirphysicalandfunctionalcharacteristics.Monocytesandneutrophilsarephagocytic.Furthersubtypescanbeclassified.
Granulocytesaredistinguishedfromagranulocytesbytheirnucleusshape(lobedversusround,thatis,polymorphonuclearversusmononuclear)andbytheir
cytoplasmgranules(presentorabsent,ormoreprecisely,visibleonlightmicroscopyornotthusvisible).Theotherdichotomyisbylineage:Myeloidcells
(neutrophils,monocytes,eosinophilsandbasophils)aredistinguishedfromlymphoidcells(lymphocytes)byhematopoieticlineage(cellulardifferentiation
lineage).[5]LymphocytescanbefurtherclassifiedasTcells,Bcells,andnaturalkillercells.
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3Drenderingofvarioustypesof
whitebloodcells

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Type

WhitebloodcellWikipedia

Microscopic
appearance

Diagram

Approx.%
inadults
Seealso:
Bloodvalues

Neutrophil

62%

Diameter
(m)[6]

Maintargets[4]

1012

Bacteria
Fungi

Nucleus[4] Granules[4] Lifetime[6]

Fine,
faintlypink
Multilobed
(H&E
stain)

6hours
fewdays
(daysin
spleenand
other
tissue)

Fullof
pinkorange
(H&E
stain)

812days
(circulate
for45
hours)

Eosinophil

2.3%

1012

Largerparasites
Bilobed
Modulateallergicinflammatoryresponses

Basophil

0.4%

1215

Releasehistamineforinflammatory
responses

Bilobed
ortri
lobed

Largeblue

Afew
hourstoa
fewdays

Small
lymphocytes7
8Large
lymphocytes
1215

Bcells:releasesantibodiesandassists
activationofTcells
Tcells:
CD4+Th(Thelper)cells:activate
andregulateTandBcells
CD8+cytotoxicTcells:virus
infectedandtumorcells.
Tcells:bridgebetweeninnate
Deeply
andadaptiveimmuneresponses
staining,
phagocytosis
eccentric
Regulatory(suppressor)Tcells:
Returnsthefunctioningofthe
immunesystemtonormaloperation
afterinfectionprevents
autoimmunity
Naturalkillercells:virusinfectedand
tumorcells.

NKcells
and
cytotoxic
(CD8+)T
cells

Yearsfor
memory
cells,
weeksfor
allelse.

Lymphocyte

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30%

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Monocyte

WhitebloodcellWikipedia

5.3%

1530[7]

Monocytesmigratefromthebloodstreamto
othertissuesanddifferentiateintotissueresident Kidney
shaped
macrophages,Kupffercellsintheliver.

None

Hoursto
days

Neutrophil
Neutrophilsarethemostabundantwhitebloodcell,constituting6070%ofthecirculatingleukocytes.[4]Theydefendagainst
bacterialorfungalinfection.Theyareusuallyfirstresponderstomicrobialinfectiontheiractivityanddeathinlarge
numbersformspus.Theyarecommonlyreferredtoaspolymorphonuclear(PMN)leukocytes,although,inthetechnical
sense,PMNreferstoallgranulocytes.Theyhaveamultilobednucleus,whichconsistsofthreetofivelobesconnectedby
slenderstrands.[8]Thisgivestheneutrophilstheappearanceofhavingmultiplenuclei,hencethenamepolymorphonuclear
leukocyte.Thecytoplasmmaylooktransparentbecauseoffinegranulesthatarepalelilacwhenstained.Neutrophilsare
activeinphagocytosingbacteriaandarepresentinlargeamountinthepusofwounds.Thesecellsarenotabletorenewtheir
lysosomes(usedindigestingmicrobes)anddieafterhavingphagocytosedafewpathogens.[9]Neutrophilsarethemost
commoncelltypeseenintheearlystagesofacuteinflammation.Thelifespanofacirculatinghumanneutrophilisabout5.4
days.[10]

Eosinophil

Neutrophilengulfinganthrax
bacteria

Eosinophilscomposeabout24%oftheWBCtotal.Thiscountfluctuatesthroughouttheday,seasonally,andduring
menstruation.Itrisesinresponsetoallergies,parasiticinfections,collagendiseases,anddiseaseofthespleenandcentral
nervoussystem.Theyarerareintheblood,butnumerousinthemucousmembranesoftherespiratory,digestive,andlowerurinarytracts.[8]

Theyprimarilydealwithparasiticinfections.Eosinophilsarealsothepredominantinflammatorycellsinallergicreactions.Themostimportantcausesof
eosinophiliaincludeallergiessuchasasthma,hayfever,andhivesandalsoparasiticinfections.Theysecretechemicalsthatdestroytheselargeparasites,suchas
hookwormsandtapeworms,thataretoobigforanyoneWBCtophagocytize.Ingeneral,theirnucleusisbilobed.Thelobesareconnectedbyathinstrand.[8]
Thecytoplasmisfullofgranulesthatassumeacharacteristicpinkorangecolorwitheosinstaining.

Basophil
Basophilsarechieflyresponsibleforallergicandantigenresponsebyreleasingthechemicalhistaminecausingthedilationofbloodvessels.Becausetheyarethe
rarestofthewhitebloodcells(lessthan0.5%ofthetotalcount)andsharephysicochemicalpropertieswithotherbloodcells,theyaredifficulttostudy.[11]They
canberecognizedbyseveralcoarse,darkvioletgranules,givingthemabluehue.Thenucleusisbiortrilobed,butitishardtoseebecauseofthenumberof
coarsegranulesthathideit.
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Theyexcretetwochemicalsthataidinthebody'sdefenses:histamineandheparin.Histamineisresponsibleforwideningbloodvesselsandincreasingtheflowof
bloodtoinjuredtissue.Italsomakesbloodvesselsmorepermeablesoneutrophilsandclottingproteinscangetintoconnectivetissuemoreeasily.Heparinisan
anticoagulantthatinhibitsbloodclottingandpromotesthemovementofwhitebloodcellsintoanarea.Basophilscanalsoreleasechemicalsignalsthatattract
eosinophilsandneutrophilstoaninfectionsite.[8]

Lymphocyte
Lymphocytesaremuchmorecommoninthelymphaticsystemthaninblood.Lymphocytesaredistinguishedbyhavingadeeplystainingnucleusthatmaybe
eccentricinlocation,andarelativelysmallamountofcytoplasm.Lymphocytesinclude:
Bcellsmakeantibodiesthatcanbindtopathogens,blockpathogeninvasion,activatethecomplementsystem,andenhancepathogendestruction.
Tcells:
CD4+helperTcells:TcellsdisplayingcoreceptorCD4areknownasCD4+Tcells.ThesecellshaveTcellreceptorsandCD4moleculesthat,in
combination,bindantigenicpeptidespresentedonmajorhistocompatibilitycomplex(MHC)classIImoleculesonantigenpresentingcells.HelperT
cellsmakecytokinesandperformotherfunctionsthathelpcoordinatetheimmuneresponse.InHIVinfection,theseTcellsarethemainindexto
identifytheindividual'simmunesystemintegrity.
CD8+cytotoxicTcells:TcellsdisplayingcoreceptorCD8areknownasCD8+Tcells.ThesecellsbindantigenspresentedonMHCIcomplexof
virusinfectedortumourcellsandkillthem.NearlyallnucleatedcellsdisplayMHCI.
TcellspossessanalternativeTcellreceptor(differentfromtheTCRfoundonconventionalCD4+andCD8+Tcells).Foundintissuemore
commonlythaninblood,TcellssharecharacteristicsofhelperTcells,cytotoxicTcells,andnaturalkillercells.
NaturalkillercellsareabletokillcellsofthebodythatdonotdisplayMHCclassImolecules,ordisplaystressmarkerssuchasMHCclassIpolypeptide
relatedsequenceA(MICA).DecreasedexpressionofMHCclassIandupregulationofMICAcanhappenwhencellsareinfectedbyavirusorbecome
cancerous.

Monocyte
Monocytes,thelargesttypeofWBCs,sharethe"vacuumcleaner"(phagocytosis)functionofneutrophils,butaremuchlongerlivedastheyhaveanextrarole:
theypresentpiecesofpathogenstoTcellssothatthepathogensmayberecognizedagainandkilled.Thiscausesanantibodyresponsetobemounted.Monocytes
eventuallyleavethebloodstreamandbecometissuemacrophages,whichremovedeadcelldebrisaswellasattackmicroorganisms.Neitherdeadcelldebrisnor
attackingmicroorganismscanbedealtwitheffectivelybytheneutrophils.Unlikeneutrophils,monocytesareabletoreplacetheirlysosomalcontentsandare
thoughttohaveamuchlongeractivelife.Theyhavethekidneyshapednucleusandaretypicallyagranulated.Theyalsopossessabundantcytoplasm.
Oncemonocytesmovefromthebloodstreamoutintothebodytissues,theyundergochanges(differentiate)allowingphagocytosisandarethenknownas
macrophages.

Fixedleucocytes
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Someleucocytesmigrateintothetissuesofthebodytotakeupapermanentresidenceat
thatlocationratherthanremainingintheblood.Oftenthesecellshavespecificnames
dependinguponwhichtissuetheysettlein,suchasfixedmacrophagesintheliver,which
becomeknownasKupffercells.Thesecellsstillservearoleintheimmunesystem.
Histiocytes
Dendriticcells(Althoughthesewilloftenmigratetolocallymphnodesupon
ingestingantigens)
Mastcells
Microglia

Disorders
Thetwocommonlyusedcategoriesofwhitebloodcelldisordersdividethemquantitatively
intothosecausingexcessivenumbers(proliferativedisorders)andthosecausinginsufficient
numbers(leukopenias).[12]Leukocytosisisusuallyhealthy(e.g.,fightinganinfection),butit
alsomaybedysfunctionallyproliferative.WBCproliferativedisorderscanbeclassedas
myeloproliferativeandlymphoproliferative.Someareautoimmune,butmanyare
neoplastic.
Anotherwaytocategorizedisordersofwhitebloodcellsisqualitatively.Therearevarious
disordersinwhichthenumberofwhitebloodcellsisnormalbutthecellsdonotfunction
normally.[13]

HSC=Hematopoieticstemcell,Progenitor=Progenitorcell,L
blast=Lymphoblast,Lymphocyte,Moblast=Monoblast,Monocyte,
Myeloblast,ProM=Promyelocyte,Myelocyte,Meta
M=Metamyelocyte,Neutrophil,Eosinophil,Basophil,Pro
E=Proerythroblast,BasoE=Basophilicerythroblast,poly
E=Polychromaticerythroblast,OrthoE=Orthochromaticerythroblast,
Erythrocyte,Promegakaryocyte,Megakaryocyte,Platelet

NeoplasiaofWBCscanbebenignbutisoftenmalignant.Ofthevarioustumorsofthebloodandlymph,cancersofWBCscanbebroadlyclassifiedasleukemias
andlymphomas,althoughthosecategoriesoverlapandareoftengroupedasapair.

Leucopenias
Arangeofdisorderscancausedecreasesinwhitebloodcells.Thistypeofwhitebloodcelldecreasedisusuallytheneutrophil.Inthiscasethedecreasemaybe
calledneutropeniaorgranulocytopenia.Lesscommonly,adecreaseinlymphocytes(calledlymphocytopeniaorlymphopenia)maybeseen.[12]
Neutropenia
Neutropeniacanbeacquiredorintrinsic.[14]Adecreaseinlevelsofneutrophilsonlabtestsisduetoeitherdecreasedproductionofneutrophilsorincreased
removalfromtheblood.[12]Thefollowinglistofcausesisnotcomplete.
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Medicationschemotherapy,sulfasorotherantibiotics,phenothiazenes,benzodiazepines,antithyroids,anticonvulsants,quinine,quinidine,indomethacin,
procainamide,thiazides
Radiation
Toxinsalcohol,benzenes
IntrinsicdisordersFanconi's,Kostmann's,cyclicneutropenia,ChediakHigashi
Immunedysfunctiondisordersofcollagen,AIDS,rheumatoidarthritis
Bloodcelldysfunctionmegaloblasticanemia,myelodysplasia,marrowfailure,marrowreplacement,acuteleukemia
Anymajorinfection
Miscellaneousstarvation,hypersplenism
Symptomsofneutropeniaareassociatedwiththeunderlyingcauseofthedecreaseinneutrophils.Forexample,themostcommoncauseofacquiredneutropeniais
druginduced,soanindividualmayhavesymptomsofmedicationoverdoseortoxicity.Treatmentisalsoaimedattheunderlyingcauseoftheneutropenia.[15]One
severeconsequenceofneutropeniaisthatitcanincreasetheriskofinfection.[13]
Lymphocytopenia
Definedastotallymphocytecountbelow1.0x109/L,thecellsmostcommonlyaffectedareCD4+Tcells.Likeneutropenia,lymphocytopeniamaybeacquiredor
intrinsicandtherearemanycauses.[13]Thisisnotacompletelist.
Inheritedimmunedeficiencyseverecombinedimmunodeficiency,commonvariableimmunedeficiency,ataxiatelangiectasia,WiskottAldrichsyndrome,
immunodeficiencywithshortlimbeddwarfism,immunodeficiencywiththymoma,purinenucleosidephosphorylasedeficiency,geneticpolymorphism
Bloodcelldysfunctionaplasticanemia
Infectiousdiseasesviral(AIDS,SARS,WestNileencephalitis,hepatitis,herpes,measles,others),bacterial(TB,typhoid,pneumonia,rickettsiosis,
ehrlichiosis,sepsis),parasitic(acutephaseofmalaria)
Medicationschemotherapy(antilymphocyteglobulintherapy,alemtuzumab,glucocorticoids)
Radiation
Majorsurgery
MiscellaneousECMO,kidneyorbonemarrowtransplant,hemodialysis,kidneyfailure,severeburn,celiacdisease,severeacutepancreatitis,sarcoidosis,
proteinlosingenteropathy,strenuousexercise,carcinoma
Immunedysfunctionarthritis,systemiclupuserythematosus,Sjogrensyndrome,myastheniagravis,systemicvasculitis,Behcetlikesyndrome,
dermatomyositis,granulomatosiswithpolyangiitis
Nutritional/Dietaryalcoholabuse,zincdeficiency
Likeneutropenia,symptomsandtreatmentoflymphocytopeniaaredirectedattheunderlyingcauseofthechangeincellcounts.

Proliferativedisorders

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Anincreaseinthenumberofwhitebloodcellsincirculationiscalledleukocytosis.[12]Thisincreaseismostcommonlycausedbyinflammation.[12]Therearefour
majorcauses:increaseofproductioninbonemarrow,increasedreleasefromstorageinbonemarrow,decreasedattachmenttoveinsandarteries,decreaseduptake
bytissues.[12]Leukocytosismayaffectoneormorecelllinesandcanbeneutrophilic,eosinophilic,basophilic,monocytosis,orlymphocytosis.
Neutrophilia
Neutrophiliaisanincreaseintheabsoluteneutrophilcountintheperipheralcirculation.Normalbloodvaluesvarybyage.[13]Neutrophiliacanbecausedbya
directproblemwithbloodcells(primarydisease).Itcanalsooccurasaconsequenceofanunderlyingdisease(secondary).Mostcasesofneutrophiliaare
secondarytoinflammation.[15]
Primarycauses[15]
Conditionswithnormallyfunctioningneutrophilshereditaryneutrophilia,chronicidiopathicneutrophilia
PelgerHuetanomaly
Downsyndrome
Leukocyteadhesiondeficiency
Familialcoldurticaria
Leukemia(chronicmyelogenous(CML))andothermyeloproliferativedisorders
Surgicalremovalofspleen[16]
Secondarycauses[15]
Infection
Chronicinflammationespeciallyjuvenilerheumatoidarthritis,rheumatoidarthritis,Still'sdisease,Crohn'sdisease,ulcerativecolitis,granulomatous
infections(forexample,tuberculosis),andchronichepatitis
Cigarettesmokingoccursin2550%ofchronicsmokersandcanlastupto5yearsafterquitting
Stressexercise,surgery,generalstress
Medicationinducedcorticosteroids(forexample,prednisone,agonists,lithium)
Cancereitherbygrowthfactorssecretedbythetumororinvasionofbonemarrowbythecancer
Increaseddestructionofcellsinperipheralcirculationcanstimulatebonemarrow.Thiscanoccurinhemolyticanemiaandidiopathicthrombocytopenic
purpura
Eosinophilia

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Anormaleosinophilcountisconsideredtobelessthan0.65 109/L.[13]Eosinophilcountsarehigherinnewbornsandvarywithage,time(lowerinthemorning
andhigheratnight),exercise,environment,andexposuretoallergens.[13]Eosinophiliaisneveranormallabfinding.Effortsshouldalwaysbemadetodiscover
theunderlyingcause,thoughthecausemaynotalwaysbefound.[13]

Countingandreferenceranges
ThecompletebloodcellcountisabloodpanelthatincludestheoverallWBCcountandvarioussubsetssuchastheabsoluteneutrophilcount.Referenceranges
forbloodtestsspecifythetypicalcountsinhealthypeople.

Seealso
Leukocytepromotingfactor

References
1.Maton,D.,Hopkins,J.,McLaughlin,Ch.W.,Johnson,S.,Warner,M.Q.,
LaHart,D.,&Wright,J.D.,DeepV.Kulkarni(1997).HumanBiologyand
Health.EnglewoodCliffs,NewJersey,US:PrenticeHall.ISBN0139811761.
2.LaFleurBrooks,M.(2008).ExploringMedicalLanguage:AStudentDirected
Approach(7thed.).St.Louis,Missouri,US:MosbyElsevier.p.398.ISBN978
0323049504.
3."VitalandHealthStatisticsSeries11,No.247(03/2005)"(PDF).Retrieved
20140202.
4.BruceAlbertsAlexanderJohnsonJulianLewisMartinRaffKeithRoberts
PeterWalter(2002)."Leukocytealsoknownasmacrophagesfunctionsand
percentagebreakdown".MolecularBiologyoftheCell(4thed.).NewYork:
GarlandScience.ISBN0815340729.
5.Orkin,SHZon,LI(Feb22,2008)."SnapShot:hematopoiesis.".Cell.132(4):
712.doi:10.1016/j.cell.2008.02.013.PMID18295585.
6.Daniels,V.G.,Wheater,P.R.,&Burkitt,H.G.(1979).Functionalhistology:A
textandcolouratlas.Edinburgh:ChurchillLivingstone.ISBN0443016577.
7.Handin,RobertI.SamuelE.LuxThomasP.Stossel(2003).Blood:Principles
andPracticeofHematology(2nded.).Philadelphia:LippincottWilliamsand
Wilkins.p.471.ISBN9780781719933.Retrieved20130618.
8.Saladin,Kenneth(2012).AnatomyandPhysiology:theUnitofFormandFunction
(6ed.).NewYork:McGrawHill.ISBN9780073378251.

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9.Wheater,PaulR.Stevens,Alan(2002).Wheater'sbasichistopathology:acolour
atlasandtext(PDF).Edinburgh:ChurchillLivingstone.ISBN0443070016.
10.Pillay,J.DenBraber,I.Vrisekoop,N.Kwast,L.M.DeBoer,R.J.Borghans,
J.A.M.Tesselaar,K.Koenderman,L.(2010)."Invivolabelingwith2H2O
revealsahumanneutrophillifespanof5.4days".Blood.116(4):6257.
doi:10.1182/blood201001259028.PMID20410504.
11.Falcone,FrancoHaas,HelmutGibbs,Bernard(15December2000)."Thehuman
basophil:anewappreciationofitsroleinimmuneresponses.".Blood.96(13):
402838.PMID11110670.
12.VinayKumaretal.(2010).RobbinsandCotranpathologicbasisofdisease.(8th
ed.).Philadelphia,PA:Saunders/Elsevier.ISBN1416031219.
13.KennethKaushanskyetal.,eds.(2010).Williamshematology(8thed.).NewYork:
McGrawHillMedical.ISBN0071621512.
14.RichardA.McPhersonMatthewR.PincusNaifZ.AbrahamJr.etal.(eds.).
Henry'sclinicaldiagnosisandmanagementbylaboratorymethods(22nded.).
Philadelphia,PA:Elsevier/Saunders.ISBN1437709745.
15.LeeGoldmanAndrewI.Schafer(eds.).Goldman'sCecilmedicine(24thed.).
Philadelphia:Elsevier/Saunders.ISBN1437716040.
16.McBride,JADacie,JVShapley,R(Feb1968)."Theeffectofsplenectomyon
theleucocytecount.".Britishjournalofhaematology.14(2):22531.
doi:10.1111/j.13652141.1968.tb01489.x.PMID5635603.

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Externallinks
AtlasofHematology(http://www.hematologyatlas.com/)
Leukocytes(https://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Leukocytes)attheUSNationalLibrary
ofMedicineMedicalSubjectHeadings(MeSH)

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