"The Most Common Blood and Lymph Disorders" is a good example of a paper on the cardiovascular system. Pathophysiology of blood and lymph disorders: What is the possible diagnosis? Given that the 6-year-old boy is noticed with bruises on his arms and legs and his blood tests also indicate increased lymphocyte count, the possible diagnosis is Chronic Lymphocytic Leukemia (CLL). Lymphocytes form an important component of the immune system and have a certain lifespan. In this form of cancer, the DNA of lymphocytes which are formed in the bone marrow starts getting damaged due to which the abnormal lymphocytes start growing in number gradually affecting the entire body's system and primarily weakening the immune system.
A healthy and strong immune system defends the body against different infections, but a person becomes susceptible to different infections like cold, sore throat, and cough, etc. if the defense mechanisms are weakened by a large number of abnormal lymphocytes accumulating in the blood. What would be the next investigation? The first investigation for CLL is always formed by blood tests, which reveal an increased lymphocyte count.
Though the diagnosis is largely made based on blood tests, the physician can order investigations like bone marrow biopsy and aspiration, also in addition to a CT scan of bones. These investigations are necessary to assess the extent to which cancer has spread and are also important for the staging of cancer. Other investigations include routine biochemistry, immunoglobulin levels to assess lymphocytosis, and Coomb's test, which is important for lymphoproliferative disorders such as CLL. What would be the patient's hemoglobin level? Anemia is a common side effect of CLL, and therefore the significant influence is exerted on the patient hemoglobin level.
Normal Hgb level in children is 111-160 g/L, but in this case, the patient's hemoglobin level would be less than 110 g/L, which indicates a high-risk stage of CLL. High levels are decreased whenever there is the infiltration of bone marrow with CLL. What would be the level of thrombocytes? Low level of platelets or thrombocytopenia also forms one of the advanced CLL symptoms, and in this case, the platelet count would be less than 110 billion/L in contrast to the normal range of 150-450 billion/L of blood.
Platelets prevent and stop bleeding. It is because the platelet count drops to a markedly low level that bruising abnormalities result in the case of this child who suffers from an advanced stage of CLL. Will there be pain associated with this condition? Though the skin bruises are painless and so often go unnoticed, there is certainly fatigue and head rushes associated with CLL. Fatigue forms one of the most common features of CLL, and patients remain tired all the time. Then there are bad head rushes due to anemia and low Hgb levels producing a condition called pulsating tinnitus.
Also, there are bad leg cramps, especially at night, as the defense mechanisms are weakened, so there might occur painful infections like sore throat and chronic cough also. What would be the treatment for this boy? Chemotherapy is used for treating patients with CLL, which targets abnormal lymphocytes and kills them. Steroids may also be used alongside chemotherapy. Monoclonal antibodies can also be given to the boy mentioned in the case, which targets the immature cells and kills them.
Bone marrow transplant is also an option though highly expensive, and high radiation may also be used to kill the immature cells if antibodies fail to serve the purpose.