Table des matières |
| Preface, | xiii |
| Acknowledgements, | xv |
| List of Abbreviations, | xvii |
| About the Companion Website, | xxi |
1. | Introduction to Blood Science, | 1 |
1.1. | What is blood science?, | 1 |
1.2. | Biochemistry, | 6 |
1.3. | Blood transfusion, | 8 |
1.4. | Genetics, | 10 |
1.5. | Haematology, | 14 |
1.6. | Immunology, | 17 |
1.7. | The role of blood science in modern healthcare, | 19 |
1.8. | What this book will achieve, | 22 |
| Summary, | 23 |
| References, | 23 |
| Further reading, | 23 |
| Web sites, | 23 |
2. | Analytical Techniques in Blood Science, | 25 |
2.1. | Venepuncture, | 25 |
2.2. | Anticoagulants, | 26 |
2.3. | Sample identification and tracking, | 27 |
2.4. | Technical and analytical confidence, | 27 |
2.5. | Major techniques, | 32 |
2.6. | Molecular genetics, | 43 |
2.7. | Point of care testing, | 47 |
2.8. | Health and safety in the laboratory, | 48 |
| Summary, | 49 |
| Further reading, | 50 |
| Web sites, | 50 |
3. | The Physiology of the Red Blood Cell, | 51 |
3.1. | Introduction, | 51 |
3.2. | The development of blood cells, | 52 |
3.3. | Erythropoiesis, | 56 |
3.4. | The red cell membrane, | 58 |
3.5. | The cytoplasm of the red cell, | 60 |
3.6. | Oxygen transport, | 66 |
3.7. | Recycling the red cell, | 68 |
3.8. | Red cell indices in the full blood count, | 69 |
3.9. | Morphology of the red cell, | 72 |
| Summary, | 74 |
| Further reading, | 74 |
4. | The Pathology of the Red Blood Cell, | 75 |
4.1. | Introduction: diseases of red cells, | 75 |
4.2. | Anaemia resulting from attack on, or stress to, the bone marrow, | 78 |
4.3. | Anaemia due to deficiency, | 80 |
4.4. | Intrinsic defects in the red cell, | 85 |
4.5. | External factors acting on healthy cells, | 100 |
4.6. | Erythrocytosis and polycythaemia, | 103 |
4.7. | Molecular genetics and red cell disease, | 105 |
4.8. | Inclusion bodies, | 105 |
4.9. | Case studies, | 105 |
| Summary, | 107 |
| References, | 107 |
| Further reading, | 107 |
5. | White Blood Cells in Health and Disease, | 109 |
5.1. | Introduction, | 109 |
5.2. | Leukopoiesis, | 111 |
5.3. | Neutrophils, | 115 |
5.4. | Lymphocytes, | 116 |
5.5. | Monocytes, | 117 |
5.6. | Eosinophils, | 118 |
5.7. | Basophils, | 119 |
5.8. | Leukocytes in action, | 120 |
5.9. | White cells in clinical medicine, | 127 |
5.10. | Case studies, | 132 |
| Summary, | 132 |
| Further reading, | 133 |
6. | White Blood Cell Malignancy, | 135 |
6.1. | The genetic basis of leukocyte malignancy, | 135 |
6.2. | Tissue techniques in haemato-oncology, | 139 |
6.3. | Leukaemia, | 141 |
6.4. | Lymphoma, | 149 |
6.5. | Myeloma and related conditions, | 152 |
6.6. | Myelofibrosis and myelodysplasi4, | 157 |
6.7. | Case studies, | 157 |
| Summary, | 158 |
| Further reading, | 159 |
| Guidelines, | 159 |
7. | The Physiology and Pathology of Haemostasis, | 161 |
7.1. | The blood-vessel wall, | 162 |
7.2. | Platelets, | 163 |
7.3. | The coagulation pathway, | 165 |
7.4. | Haemostasis as the balance between thrombus formation and removal, | 168 |
7.5. | The haemostasis laboratory, | 171 |
7.6. | The pathology of thrombosis, | 173 |
| Summary, | 175 |
| Further reading, | 175 |
8. | The Diagnosis and Management of Disorders of Haemostasis, | 177 |
8.1. | Thrombosis 1: overactive platelets and thrombocytosis, | 177 |
8.2. | Thrombosis 2: overactive coagulation, | 181 |
8.3. | Haemorrhage 1: platelet underactivity and thrombocytopenia, | 193 |
8.4. | Haemorrhage 2: coagulation underactivity, | 199 |
8.5. | Disseminated intravascular coagulation, | 203 |
8.6. | Molecular genetics in haemostasis, | 204 |
8.7. | Case studies, | 205 |
| Summary, | 206 |
| References, | 206 |
| Further reading, | 207 |
| Guidelines, | 207 |
| Web sites, | 207 |
9. | Immunopathology, | 209 |
9.1. | Introduction, | 209 |
9.2. | Basics of the immune system, | 210 |
9.3. | Humoral immunity, | 212 |
9.4. | Immunopathology 1: immunodeficiency, | 215 |
9.5. | Immunopathology 2: hypersensitivity, | 221 |
9.6. | Immunopathology 3: autoimmune disease, | 226 |
9.7. | Immunotherapy, | 232 |
9.8. | The immunology laboratory, | 234 |
9.9. | Case studies, | 238 |
| Summary, | 239 |
| References, | 240 |
| Further reading, | 240 |
| Guidelines, | 240 |
| Web sites, | 240 |
10. | Immunogenetics and Histocompatibility, | 241 |
10.1. | The genetics of antigen recognition, | 241 |
10.2. | Human leukocyte antigens, | 245 |
10.3. | Transplantation, | 251 |
10.4. | Autoimmunity and human leukocyte antigens, | 257 |
| Summary, | 260 |
| Further reading, | 260 |
| Guidelines, | 260 |
| Web sites, | 260 |
11. | Blood Transfusion, | 261 |
11.1. | Blood collection and processing, | 262 |
11.2. | Blood groups, | 265 |
11.3. | Laboratory practice of blood transfusion, | 273 |
11.4. | Clinical practice of blood transfusion, | 279 |
11.5. | Hazards of blood transfusion, | 281 |
| Summary, | 284 |
| References, | 284 |
| Further reading, | 284 |
| Guidelines, | 284 |
| Web sites, | 285 |
12. | Waste Products, Electrolytes and Renal Disease, | 287 |
12.1. | Renal anatomy and physiology, | 287 |
12.2. | Homeostasis, | 288 |
12.3. | Excretion, | 295 |
12.4. | Renal endocrinology, | 297 |
12.5. | Renal disease, | 298 |
12.6. | Case studies, | 301 |
| Summary, | 303 |
| Further reading, | 303 |
| Guidelines, | 303 |
| Web sites, | 303 |
13. | Hydrogen Ions, pH, and Acid-Base Disorders, | 305 |
13.1. | Ions and molecules, | 305 |
13.2. | Blood gases, | 308 |
13.3. | Acidosis (pH <7.3), | 312 |
13.4. | Alkalosis (pH >7.5), | 313 |
13.5. | Mixed acid-base conditions, | 314 |
13.6. | Clinical interpretation, | 314 |
13.7. | Case studies, | 315 |
| Summary, | 316 |
| Further reading, | 317 |
| Web site, | 317 |
14. | Glucose, Lipids and Atherosclerosis, | 319 |
14.1. | Glucose, | 319 |
14.2. | Dyslipidaemia, | 333 |
14.3. | Atherosclerosis, | 343 |
14.4. | Case studies, | 347 |
| Summary, | 348 |
| Further reading, | 348 |
| Guidelines, | 349 |
| Web sites, | 349 |
15. | Calcium, Phosphate, Magnesium and Bone Disease, | 351 |
15.1. | Calcium, | 352 |
15.2. | Phosphates, | 355 |
15.3. | Magnesium, | 355 |
15.4. | The laboratory, | 355 |
15.5. | Disorders of calcium homeostasis, | 357 |
15.6. | Disorders of phosphate homeostasis, | 360 |
15.7. | Disorders of magnesium homeostasis, | 362 |
15.8. | Bone physiology, | 363 |
15.9. | Bone disease, | 364 |
15.10. | Case studies, | 368 |
| Summary, | 369 |
| Further reading, | 370 |
| Guidelines, | 370 |
| Web sites, | 370 |
16. | Nutrients and Gastrointestinal Disorders, | 371 |
16.1. | Nutrients, | 371 |
16.2. | The intestines, | 375 |
16.3. | Case studies, | 381 |
| Summary, | 382 |
| Further reading, | 382 |
| Guidelines, | 382 |
17. | Liver Function Tests and Plasma Proteins, | 383 |
17.1. | Anatomy and physiology of the liver, | 384 |
17.2. | Liver function tests, | 389 |
17.3. | Diseases of the liver, | 390 |
17.4. | Plasma proteins, | 396 |
17.5. | Case studies, | 405 |
| Summary, | 406 |
| Further reading, | 406 |
| Web sites, | 406 |
18. | Hormones and Endocrine Disorders, | 407 |
18.1. | Endocrine physiology, | 407 |
18.2. | The pathology of the endocrine system, | 417 |
18.3. | Case studies, | 434 |
| Summary, | 435 |
| Further reading, | 435 |
| Web sites, | 436 |
19. | Cancer and Tumour Markers, | 437 |
19.1. | General concepts in cancer biology, | 437 |
19.2. | Blood science and cancer, | 440 |
19.3. | Molecular genetics, | 444 |
19.4. | Case studies, | 445 |
| Summary, | 446 |
| Further reading, | 446 |
| Guidelines, | 447 |
| Web sites, | 447 |
20. | Inherited Metabolic Disorders, | 449 |
20.1. | The genetics of inheritance, | 449 |
20.2. | Molecular inherited metabolic disorders, | 451 |
20.3. | Organelle inherited metabolic disorders, | 455 |
20.4. | Antenatal diagnosis and neonatal screening, | 455 |
20.5. | Case studies, | 456 |
| Summary, | 457 |
| Further reading, | 457 |
21. | Drugs and Poisons, | 459 |
21.1. | Toxicology, | 459 |
21.2. | Toxicology of specific compounds, | 461 |
21.3. | Therapeutic drug monitoring, | 465 |
21.4. | Case studies, | 468 |
| Summary, | 469 |
| References, | 469 |
| Further reading, | 469 |
22. | Case Reports in Blood Science, | 471 |
| Abbreviations, | 471 |
| Case report 1, | 472 |
| Anaemia, hypercalcaemia, proteinuria, myeloma | |
| Case report 2, | 473 |
| Diabetes, glycated haemoglobin, chronic renal failure | |
| Case report 3, | 474 |
| Acute kidney injury, leucocytosis, neutrophilia, viruses | |
| Case report 4, | 475 |
| Part 1: Obesity, colorectal cancer, CEA, hypothyroidism. Part 2: Alcoholism, raised GGT and triacylglycerols | |
| Case report 5, | 477 |
| Part 1: No abnormalities. Part 2: Asthma, raised IgE. Part 3: Falling haemoglobin, rising ESR, lung cancer | |
| Case report 6, | 479 |
| Hypothyroidism, marginally reduced haemoglobin | |
| Case report 7, | 480 |
| Raised CRP, ESR, rheumatoid factor and anti-nuclear antibodies; borderline anti-dsDNA antibodies, low C3, low eGFR and so mild renal failure, systemic lupus erythematosus | |
| Case report 8, | 481 |
| Normal blood results in renal transplantation | |
| Case report 9, | 482 |
| Falling albumin, eGFR, haemoglobin, red cell count and platelets, rising ESR, white cell count and neutrophila, CRP, urea and creatinine, septicaemia | |
| Case report 10, | 484 |
| Microcytic anaemia, thrombocytopenia, lymphocytosis, abnormal LFTs, falling albumin, raised CRP, myositis with raised CK, viruses | |
| Case report 11, | 486 |
| Acidosis, hyperglycaemia, diabetic ketoacidosis, acute renal injury, raised urea and creatinine | |
| Case report 12, | 487 |
| Low haemoglobin, thrombocytopenia, raised CRP and d-dimers, abnormal LFTs, malaria, pregnancy | |
| Case report 13, | 488 |
| Raised aldosterone, hypernatraemia, hypokalaemia, Conn's syndrome | |
| Case report 14, | 489 |
| Paediatric diabetic ketoacidosis, hyperglycaemia, low bicarbonate, raised phosphates, ALP and proteins | |
| References, | 490 |
| Appendix: Reference Ranges, | 491 |
| Further Reading, | 493 |
| Glossary, | 495 |
| Index, | 519 |