Immunology Course Outline

Immunology Course Outline - Session 1

The Cast of Characters - Review of Histology, Anatomy, and Terminology

Sets of Laboratory Findings to Interpret

Patient 1:	Laboratory Findings	Click here for normal laboratory values
CBC:
	Hgb	13.9 g/dL
	Hct	42.0%
	MCV	92 fL
	Platelets	184,000/microliter
	WBC count	13,300/microliter
	WBC diff	80 segs, 7 bands, 7 lymphs, 6 monos

Chemistry:
	C-Reactive Protein	2.2 mg/dL
	Albumin	4.2 g/dL
	Total Protein	7.2 g/dL

Patient 2:	Laboratory Findings:	Click here for normal laboratory values
CBC:
	Hgb	12.2 g/dL
	Hct	36.6.0%
	MCV	98 fL
	Platelets	237,000/microliter
	WBC count	2,900/microliter
	WBC diff	73 segs, 4 bands, 11 lymphs, 12 monos

	Albumin	3.6 g/dL
	Total Protein	6.3 g/dL

Patient 3:	Laboratory Findings	Click here for normal laboratory values
CBC:
	Hgb	11.2 g/dL
	Hct	33.3%
	MCV	85 fL
	Platelets	74,000/microliter
	WBC count	3,850/microliter
	WBC diff	59 segs, 2 bands, 25 lymphs, 13 monos, 1 baso

Chemistry:
	Complement C3	62 mg/dL
	Complement C4	11 mg/dL
	Albumin	3.7 g/dL
	Total Protein	8.2 g/dL
	Antinuclear Antibody Test	Positive with titer of 1:1024

ANSWERS

Patient 1: The findings suggest an acute inflammatory or infectious process. There is an increased WBC count with a "left shift" indicated by the high band neutrophil count. The C-reactive protein, a sensitive indicator of acute inflammation, is elevated.

Patient 2: The findings are consistent with an immunodeficiency state with decreased numbers of lymphocytes. The amount of globulin (total protein - albumin) appears normal. One would want to determine lymphocyte subsets to determine what was missing (B cells, CD4 cells, CD8 cells, others). The patient has a mild normocytic anemia.

Patient 3: The decreased complement and the positive antinuclear antibody test suggest an autoimmune disease with antigen-antibody deposition and complement activation. There is a pancytopenia with reductions in RBCs, WBCs, and platelets, typical for a disease such as systemic lupus erythematosus (SLE).