Case Studies in Hematology: Nonmalignant WBC Disorders

Author: Margaret Reinhart, MS, MLS(ASCP)
Reviewers: Laurie Bjerklie, MA, MLS(ASCP)CM and Kyle Magee, MBA, MLS(ASCP)CM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Hematology): 1 hour(s)

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Objectives

  • Correlate laboratory data with patient history, signs, and symptoms.
  • Recognize abnormalities in the CBC and other hematology test results as they pertain to the cases presented.
  • Analyze the laboratory data and other information given in the case.
  • Propose possible diagnoses as well as additional laboratory tests which will help to arrive at a definitive diagnosis of the case.
  • Explain the pathophysiological concepts of the particular disorder which was diagnosed.

Course Outline

  • An Introduction to the Case Studies
    • WBC Cases in this Course
  • A Teenager with Low Neutrophil Count
    • History and Lab Results
    • Interpretation of Lab Results and Further History
    • Diagnosis
    • Description of Benign Ethnic Neutropenia
    • Differential Diagnosis
    • Genetics
    • What is the usual absolute neutrophil count in benign ethnic neutropenia (BEN) patients?
    • Patients with BEN usually have what signs and symptoms?
    • Benign ethnic neutropenia (BEN) is associated with what blood type?
  • A 50-year-old with Respiratory Infection and Monocytosis
    • Clinical Presentation and Initial Lab Results
    • Interpretation of Lab Results and Further Findings
    • Diagnosis
    • Possible Causes of Monocytosis
    • Reactive Monocytosis
    • Clonal Monocytosis
    • True or False: A neoplasm of some sort generally causes persistent monocytosis.
    • Possible neoplasms in which a monocytosis can be seen include all of the following except:
    • Monocytosis frequently occurs in people with what infection?
  • A 61-year-old with Moderate to Severe COVID-19 Infection
    • Clinical Presentation and Initial Lab Results
    • Lab Results Upon Transfer to ICU
    • Morphological Changes in White Blood Cells
    • CBC Results and COVID-19: Possible Biomarkers?
    • Blood Cell Changes in Severe COVID-19 Infections
    • Choose one possible CBC test that indicates increasing COVID disease severity.
    • Which of the following possible changes in WBC morphology seem to be seen in increasingly severeCOVID cases?
  • A 43-year-old with Asthma and Unexplained Basophilia
    • Patient History and Lab Results
    • Peripheral Blood Smear
    • Interpretation and Discussion
    • Inaccuracies with Basophil Counts
    • Possible Causes of Reactive Basophilia
    • Neoplastic Causes of Basophilia
    • Resolution of Case
    • Spurious basophil counts from a hematology analyzer can be caused by all of the following (depending on the analyzer) except:
    • What is the most common neoplastic cause of basophilia?
  • A 55-year-old with Anemia, Leukopenia, and Thrombocytopenia
    • Clinical Presentation and Lab Results
    • Interpretation of CBC and Additional Lab Results
    • Blood Smear Results and Confirmatory Tests
    • Human Granulocytic Anaplasmosis
    • Laboratory Diagnosis
    • Typical findings in the CBC of a patient with human granulocytic anaplasmosis (HGA) include which of the following?
    • Recommended confirmatory tests for HGA include which of the following?
  • References
    • References

Additional Information

Level of Instruction: Intermediate 
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Margaret Reinhart, MS, MLS(ASCP), is a senior lecturer at the University of the Sciences, where she has taught Hematology since 1990. She was also director of the Medical Laboratory Science Program from 199 to 2020. In addition, she is an adjunct instructor of Hematology at the Pennsylvania Hospital Medical Laboratory Science program, which is part of the Hospital of the University of Pennsylvania.  
The author has no conflict of interest to disclose.
Reviewer Information:
Laurie Bjerklie, MA, MLS(ASCP)CM, is a Lead Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
Kyle Magee, MBA, MLS(ASCP)CM, has experience as an Education Specialist for the Department of Clinical Microbiology at Mayo Clinic, Florida. He has also been an instructor at the Florida State College at Jacksonville (FSCJ) and a professor at Santa Fe College, where he taught classes in various disciplines of Laboratory Medicine. Kyle has given several presentations at both local and regional levels in Florida. He holds a Master’s in Business Administration with a concentration in Healthcare Management and has received the Top 25 student award through the Davis College of Business.
Course Description: This course presents case studies pertaining to both non-malignant white blood cell disorders and malignant/neoplastic disorders. Each case is presented followed by several pertinent questions.  Answers for each question are then given along with a brief discussion to explain these answers. The student will then have the opportunity to answer questions based on the concepts learned in the case.