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Fulltext Reduction in Absolute Neutrophil Counts in Patient on Clozapine Infected with COVID-19

Ramli FF, Ali A, Syed Hashim SA, Kamisah Y, Ibrahim N

Int J Environ Res Public Health, 2021 10 27;18(21).
PMID: 34769806 DOI: 10.3390/ijerph182111289

Despite its severe adverse effects, such as agranulocytosis, clozapine is the primary treatment for treatment-resistant schizophrenia. The established clozapine monitoring system has contributed to reducing agranulocytosis incidence and mortality rates. However, the pandemic coronavirus disease 2019 (COVID-19) has caused changes in the monitoring system. This review aimed to assess the current evidence on the neutrophil changes in the patient on clozapine treatment and infected with COVID-19. Individual cases reported various absolute neutrophil count (ANC) levels, normal, reduced, or elevated. No agranulocytosis case was reported. One case had a borderline moderate-severe ANC level, but the patient was in the 18-week period of clozapine treatment. A cumulative analysis of case the series initially reported inconclusive results. However, a more recent study with a larger sample size reported a significant reduction in the ANC during COVID-19 infection. Nevertheless, this effect is transient as no significant difference was found between the baseline and the post-infection period in ANC levels. In conclusion, COVID-19 is associated with a temporary reduction in ANC levels. The results supported the recommendation to reduce the frequency of clozapine monitoring in the eligible candidates. However, more data are required to confirm the current findings given the limitations, including study design, sample size, and statistical analysis.

Matched MeSH terms: Leukocyte Count
Fulltext Acute appendicitis and the leucocyte count

Singh KJ

Med J Malaysia, 1980 Mar;34(3):314-6.
PMID: 7412672

The total and differential leucocyte counts were estimated in 100 consecutive cases operated for acute appendicitis. Leucocytosis was seen in 52% of cases. 480/0 of patients had a leucocyte count below 10000 per c. mm. A study of the differential count was also made to see if this parameter could be used as a specific diagnostic aid. Though the neutrophil count was high in 74% of the cases, the comparative count among the below 10000 per c.mm. group was not significant. It is concluded that the total and differential counts are of limited value in the assessment of these patients. It is suggested that such estimation be used as a supportive aid only. In those doubtful cases with normal or low counts, frequent clinical reviews should be done and reliance placed on clinical assessment rather than laboratory information.

Matched MeSH terms: Leukocyte Count*
Fulltext Comparison between flowcytometry and immunoperoxidase staining for the enumeration of lymphocyte subsets

Dhaliwal JS, Malar B, Quck CK, Sukumaran KD, Hassan K

Singapore Med J, 1991 Jun;32(3):163-5.
PMID: 1876889

Immunoperoxidase staining was compared with flowcytometry for the enumeration of lymphocyte subsets. The percentages obtained for peripheral blood lymphocytes using immunoperoxidase (CD3 = 76 CD4 = 27.9, B = 10.7 CD4/CD8 = 1.8) differed significantly from those obtained by flowcytometry (CD3 = 65.7 CD4 = 39.4, CD8 = 25.6, B = 16.7, HLA DR = 11.9 CD4/CD8 = 1.54) for certain subsets (CD3, CD4, B). There was no significant difference in lymphocyte subsets between children and adults using the same method. These differences are probably due to the different methods used to prepare lymphocytes for analysis. Other factors that should also be considered are the presence of CD4 antigen on monocytes and CD8 on natural killer cells.

Matched MeSH terms: Leukocyte Count/methods
Fulltext High white cell count at presentation in children with acute lymphoblastic leukaemia

Menon BS, Wan Maziah WM, Jackson N, Jamaluddin N, Narazah MY, Dasgupta A, et al.

Med J Malaysia, 1999 Jun;54(2):283-4.
PMID: 10972046
Matched MeSH terms: Leukocyte Count*
Human T- and B-lymphocyte populations in blood: local population studies

Pang T, Parasakthi N, Yap SF

Med J Malaysia, 1979 Mar;33(3):243-6.
PMID: 316496
Matched MeSH terms: Leukocyte Count*
Leucocyte alkaline phosphatase, leucocyte count and haemoglobin level in malayan new-borns and young infants

Lie-Injo Luan Eng, Govindasamy S

Med J Malaya, 1965 Jun;19(4):263-6.
PMID: 4220850
Matched MeSH terms: Leukocyte Count*
IDIOPATHIC HYPERSPLENISM IN A CHINESE BOY; BENEFICIAL EFFECT OF SPLENECTOMY

LIE-INJOLUAN EN, PILLAY RP

Med J Malaysia, 1963 Dec;18:95-8.
PMID: 14117288
Matched MeSH terms: Leukocyte Count*
Fulltext Optimisation of laboratory procedures for isolating human peripheral blood derived neutrophils

Maqbool M, Vidyadaran S, George E, Ramasamy R

Med J Malaysia, 2011 Oct;66(4):296-9.
PMID: 22299545 MyJurnal

Functional analysis of neutrophils requires isolation of these cells in the laboratory. Current isolation procedures are time consuming and can potentially activate the resting neutrophils. Thus, in this present study, we have optimised an existing laboratory protocol for human neutrophil isolation from peripheral blood. Twenty ml of blood samples were subjected to optimised density gradient separation and dextran sedimentation to obtain a pure population of neutrophils. The efficacy of the optimised manual post isolation of neutrophils was compared with pre isolation count performed by an automated haematology analyzer. The recovery of neutrophils via our optimised methods was 65.5% in comparison with neutrophils counts at pre-isolation. The morphological analysis of isolated neutrophils indicated the purity level more than 95% using Leishman staining. Our optimised laboratory procedures for neutrophils isolation successfully harvested neutrophils with good viability, purity and post recovery yield. This procedure provides an ideal platform to separate neutrophils for in vitro studies.

Matched MeSH terms: Leukocyte Count
Fulltext Habitat disturbance results in chronic stress and impaired health status in forest-dwelling paleotropical bats

Seltmann A, Czirják GÁ, Courtiol A, Bernard H, Struebig MJ, Voigt CC

Conserv Physiol, 2017;5(1):cox020.
PMID: 28421138 DOI: 10.1093/conphys/cox020

Anthropogenic habitat disturbance is a major threat to biodiversity worldwide. Yet, before population declines are detectable, individuals may suffer from chronic stress and impaired immunity in disturbed habitats, making them more susceptible to pathogens and adverse weather conditions. Here, we tested in a paleotropical forest with ongoing logging and fragmentation, whether habitat disturbance influences the body mass and immunity of bats. We measured and compared body mass, chronic stress (indicated by neutrophil to lymphocyte ratios) and the number of circulating immune cells between several bat species with different roost types living in recovering areas, actively logged forests, and fragmented forests in Sabah, Malaysia. In a cave-roosting species, chronic stress levels were higher in individuals from fragmented habitats compared with conspecifics from actively logged areas. Foliage-roosting species showed a reduced body mass and decrease in total white blood cell counts in actively logged areas and fragmented forests compared with conspecifics living in recovering habitats. Our study highlights that habitat disturbance may have species-specific effects on chronic stress and immunity in bats that are potentially related to the roost type. We identified foliage-roosting species as particularly sensitive to forest habitat deterioration. These species may face a heightened extinction risk in the near future if anthropogenic habitat alterations continue.

Matched MeSH terms: Leukocyte Count
Fulltext Clozapine re-challenge with lithium supplementation following clozapine-induced neutropenia

Ahmad Nabil Md Rosli, Subbiah, Rakesh, Maniam, T.

ASEAN Journal of Psychiatry, 2014;15(1):90-92.
MyJurnal

Objectives: This paper aims to report on a case in which re-challenging with clozapine in combination with lithium in a patient who developed neutropenia was carried out. Methods: The patient was treated with clozapine for treatment- resistant schizophrenia. After five weeks he showed much improvement but developed neutropenia. Withdrawal of clozapine brought on a relapse of psychotic symptoms. Subsequently, clozapine was reintroduced along with Lithium. The neutrophil count was monitored closely. Results: The neutrophil and white blood cell count were noted to return to normal upon re-challenging, and the patient’s clinical condition also improved. Conclusion: Simultaneous administration of lithium and clozapine to patients experiencing neutropenia on clozapine is a possible strategy. However, very close monitoring of the white count is needed. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 90-92.

Matched MeSH terms: Leukocyte Count
Fulltext Clozapine-induced constipation: a case report

Teh, Y.W., Teh, E.E., Russell, V.

Malaysian Journal of Psychiatry, 2014;23(1):77-80.
MyJurnal

Clozapine is an atypical antipsychotic medication, used primarily as the drug of choice in treatment resistant schizophrenia. Despite its considerable advantages, clozapine’s licence is restricted because of its potential to induce agranulocytosis. Hence, white blood cell count monitoring is mandatory in patients receiving clozapine treatment. A side effect of clozapine that has received relatively less attention is constipation, which is caused by the drug’s anticholinergic effect. This potentially serious problem can result in life- threatening bowel obstruction, ischemia, necrosis, perforation, and pulmonary aspiration. Despite this evidence, routine inquiry about constipation in clozapine treated patients is not emphasised in current clinical guidance. We report a case to highlight constipation as both a potentially serious side effect and as a factor, insufficiently recognised, in non-adherence to clozapine.

Matched MeSH terms: Leukocyte Count
Fulltext Platelet distribution width as an useful indicator of influenza severity in children

Zou S, Mohtar SH, Othman R, Hassan RM, Liang K, Lei D, et al.

BMC Infect Dis, 2024 Jan 02;24(1):9.
PMID: 38166827 DOI: 10.1186/s12879-023-08890-w

PURPOSE: The present study aims to investigate the potential of platelet distribution width as an useful parameter to assess the severity of influenza in children.
METHODS: Baseline characteristics and laboratory results were collected and analyzed. Receiver operating characteristic (ROC) curve analysis was used to joint detection of inflammatory markers for influenza positive children, and the scatter-dot plots were used to compare the differences between severe and non-severe group.
RESULTS: Influenza B positive children had more bronchitis and pneumonia (P count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), and platelet parameters performed differently among

Matched MeSH terms: Leukocyte Count
Immunological parameters of Javanese carp Puntius gonionotus (Bleeker) exposed to copper and challenged with Aeromonas hydrophila

Shariff M, Jayawardena PA, Yusoff FM, Subasinghe R

Fish Shellfish Immunol, 2001 May;11(4):281-91.
PMID: 11417716

This study was to determine the median lethal concentration (LC50) of copper to Javenese carp, Puntius gonionotus (Bleeker), and the immune response after the fish were exposed to sublethal levels of copper and challenged with formalin killed Aeromonas hydrophila. The LC50 of copper on P. gonionotus at 24, 48, 72, 96 and 120 h were estimated as 2.17, 0.91, 0.57, 0.53 and 0.42 mg l(-1), respectively. To determine the effect of copper on the immune system, fish were exposed for 66 days to 0.05, 0.10 and 0.15 mg Cu l(-1). After 56 days of initial exposure to copper, fish were challenged with 0.1 ml of 4.5 x 10(5) cfu ml(-1) formalin killed A. hydrophila and maintained in the same concentration of copper. After the challenge, the immune response was monitored for 2 weeks using haematological and serological assays. During the initial phase of exposure to copper, significant changes were noted in the white blood cell, lysozyme, potential killing activity, total plasma protein, total immunoglobulin and haematocrit levels between the control and treated fish. One week after challenge with A. hydrophila, there was a significant increase in the values of white blood cells, total protein and total immunoglobulin compared to the values before the challenge. However, these values were not significantly different (P>0.05) between the control and the treated fish. In contrast, NBT and lysozyme assays exhibited a significant difference (P<0.05) in fish exposed to 0.10 mg Cu l(-1) (0.525 +/- 0.17; 24.42 +/- 3.35 x 10(2) micromg ml(-1)) and 0.15 mg Cu 1(-1) (0.536 +/- 0.19; 21.78 +/- 1.29 x 10(2) micromg ml(-1)) compared to the control (0.746 +/- 0.31; 30.73 +/- 5.42 x 10(2) micromg ml(-1)) after the bacterial challenge (day 61). There was however no significant difference (P>0.05) in NBT and lysozyme levels in fish exposed to lower level of copper (0.05 mg Cu l(-1)), suggesting the absence of immunosuppressive effects at lower level of exposure.

Matched MeSH terms: Leukocyte Count/veterinary
Fulltext Aberrancies of human T--and B--lymphocyte populations in peripheral blood

Gan SC, Yeoh CW

Med J Malaysia, 1980 Jun;34(4):379-82.
PMID: 6971393

Strict precautions were taken in our methodology to exclude any monocytes from being included in the total T and B cell estimation. There is a progressive drop in the percentage of T and B cells with age, but no significant differences between the races nor between the sexes of the same age group. Aberrancies of T and B cell percentages were noted in most infections, malignancies and even malnutrition.

Matched MeSH terms: Leukocyte Count*
Fulltext Blood haematology, serum thyroid hormones and glutathione peroxidase status in kacang goats fed inorganic iodine and selenium supplemented diets

Aghwan ZA, Sazili AQ, Alimon AR, Goh YM, Hilmi M

Asian-Australas J Anim Sci, 2013 Nov;26(11):1577-82.
PMID: 25049744 DOI: 10.5713/ajas.2013.13180

The effects of dietary supplementation of selenium (Se), iodine (I), and a combination of both on the blood haematology, serum free thyroxine (FT4) and free triiodothyronine (FT3) hormones and glutathione peroxidase enzyme (GSH-Px) activity were examined on twenty four (7 to 8 months old, 22±1.17 kg live weight) Kacang crossbred male goats. Animals were randomly assigned to four dietary treatments (6 animals in each group). Throughout 100 d of feeding trial, the animals of control group (CON) received a basal diet, while the other three groups were offered basal diet supplemented with 0.6 mg/kg diet DM Se (SS), or 0.6 mg/kg diet DM I (PI), or a combination of both Se and I, each at 0.6 mg/kg diet DM (SSPI). The haematological attributes which are haemoglobin (Hb), red blood cell (RBC), packed cell volume (PCV), mean cell volume (MCV), white blood cells (WBC), band neutrophils (B Neut), segmented neutrophils (S Neut), lymphocytes (Lymph), monocytes (Mono), eosinophils (Eosin) and basophils (Baso) were similar among the four treatment groups, while serum levels of Se and I increased significantly (p<0.05) in the supplemented groups. The combined dietary supplementation of Se and I (SSPI) significantly increased serum FT3 in the supplemented animals. Serum GSH-Px activity increased significantly in the animals of SS and SSPI groups. It is concluded that the dietary supplementation of inorganic Se and I at a level of 0.6 mg/kg DM increased serum Se and I concentration, FT3 hormone and GSH-Px activity of Kacang crossbred male goats.

Matched MeSH terms: Leukocyte Count
Dietary administration of Bacillus thuringiensis on the cellular innate immune response of African catfish (Clarias gariepinus) against Aeromonas hydrophila

Reneshwary C, Rajalakshmi M, Marimuthu K, Xavier R

Eur Rev Med Pharmacol Sci, 2011 Jan;15(1):53-60.
PMID: 21381499

An experiment was conducted to evaluate the use of Bacillus thuringiensis (Bt) as a probiotic to enhance the cellular innate immune response of the African catfish (Clarias gariepinus) challenged with a bacterial fish pathogen, Aeromonas hydrophila.

Matched MeSH terms: Leukocyte Count
Fulltext Risk profiles of referred chronic kidney disease patients in a tertiary nephrology centre

Lim CT, R R, A S MZ

Pak J Med Sci, 2016 Mar-Apr;32(1):27-30.
PMID: 27022339 DOI: 10.12669/pjms.321.8214

OBJECTIVES: The aims of this study were to determine the seroprevalence of acute dengue in Universiti Kebangsaan Malaysia (UKM) Medical Centre and its correlation with selected haematological and biochemical parameters.
METHODS: This cross-sectional study was conducted from January to June 2015. A patient was serologically diagnosed with acute dengue if the dengue virus IgG, IgM or NS-1 antigen was reactive.
RESULTS: Out of 1,774 patients suspected to have acute dengue, 1,153 were serologically diagnosed with the infection, resulting in a seroprevalence of 64.9%. Dengue-positive patients had a lower mean platelet count (89 × 10(9)/L) compared to the dengue-negative patients (171 × 10(9)/L) (p<0.0001). The mean total white cell count was also lower in the dengue-positive cases (4.7 × 10(9)/L vs. 7.2 × 10(9)/L; p<0.0001). The mean haematocrit was higher in patients with acute dengue (42.5% vs. 40.0%; p<0.0001). Likewise, the serum alanine transaminase level was also higher in patients with acute dengue (108 U/L vs. 54 U/L; p<0.0001).
CONCLUSIONS: Dengue is very prevalent in UKM Medical Centre as most patients suspected to have acute dengue had serological evidence of the infection. The platelet count was the single most likely parameter to be abnormal (i.e. low) in patients with acute dengue.
KEYWORDS: DENV; Dengue; IgG; IgM; NS1; Seroprevalence

Matched MeSH terms: Leukocyte Count
Spectrum concept of neuroleptic malignant syndrome

Adityanjee, Singh S, Singh G, Ong S

Br J Psychiatry, 1988 Jul;153:107-11.
PMID: 3224231

Although neuroleptic malignant syndrome (NMS) was initially thought to be a rare, idiosyncratic complication, the incidence estimates have been rising over the years. A part of this increase can be explained on the basis of an over-inclusive definition of NMS. The unitary concept of NMS has been challenged recently and a spectrum concept has been enunciated on the basis of findings of retrospective chart-reviews which have used too broad a definition of NMS. The authors describe three cases of neuroleptic-related toxicity with different clinical presentations which appeared in a manner apparently supporting the spectrum concept. They discuss this controversial concept critically, however, and caution against its overzealous use in routine clinical practice owing to its far-reaching clinical implications.

Matched MeSH terms: Leukocyte Count
Fulltext Effects of honey supplementation on safety profiles among postmenopausal breast cancer patients

Zakaria Z, Zainal Abidin ZF, Gan SH, Wan Abdul Hamid WZ, Mohamed M

J Taibah Univ Med Sci, 2018 Dec;13(6):535-540.
PMID: 31435374 DOI: 10.1016/j.jtumed.2018.04.013

Objectives: In this study, we aimed to determine the effect of honey supplementation on the safety profiles of postmenopausal breast cancer patients.
Methods: Seventy-two postmenopausal women with stage I, II, or III breast cancer from the Oncology Clinic, Universiti Sains Malaysia Hospital were treated with anastrozole (1 mg/day). Patients were randomly assigned to one of the two groups (n = 36/group): a control group (no honey) and a honey group (20 g/day of honey for 12 weeks). Fasting blood samples were obtained pre- and post-intervention to investigate differences in the haematological, renal, and liver profiles of patients in both the groups.
Results: Post-intervention, alanine aminotransferase levels were significantly higher in the control group than in the honey group. In the honey group, white blood cell counts, platelet counts, and creatinine levels were significantly higher following honey supplementation for 12 weeks. Nevertheless, the values were still within normal ranges.
Conclusions: The present study suggests that honey supplementation of 20 g/day for 12 weeks is safe and beneficial for postmenopausal breast cancer patients.

Matched MeSH terms: Leukocyte Count
Fulltext An Experimental Evaluation of Adaptogenic Potential of Standardized Epipremnum Aureum Leaf Extract

Das SK, Sengupta P, Mustapha MS, Sarker MMR

J Pharm Bioallied Sci, 2017 Apr-Jun;9(2):88-93.
PMID: 28717330 DOI: 10.4103/0975-7406.183227

BACKGROUND: Stress is a normal part of everyday life but chronic stress can lead to a variety of stress-related illnesses including hypertension, anxiety, and depression. In the present investigation, standardized leaf extract of Epipremnumaureum was evaluated for its anti-stress potential.

MATERIALS AND METHODS: For the evaluation of anti-stress activity, groups of mice (n = 6) were subjected to forced swim stress and anoxic stress tolerance test in mice 1h after daily treatment of E.aureumextract. Diazepam (5 mg/kg) was taken as a reference standard. Urinary vanillylmandelic acid (VMA) and ascorbic acid were selected as noninvasive biomarkers to assess the anti-stress activity and plasma cortisol, blood ascorbic acid, and weight of adrenal were measured. The 24 h urinary excretion of VMA and ascorbic acid were determined by spectrophotometric methods in all groups under normal and stressed conditions. The hematological parameters (neutrophils, lymphocytes, and eosinophils) were also determined.

RESULTS: Administration of E.aureumat doses of 400 and 600 mg/kg wasfound to be effective in inhibiting the stress induced urinary biochemical changes in a dose-dependent manner. Treatment with E. aureum extract prevents the rise in blood ascorbic acid and plasma cortisol. Moreover, the extract prevented the increase in weight of adrenal gland also significantly increased the anoxia stress tolerance time. Dose-dependent significant reduction in white blood cell count was observed in anoxic stress tolerance test as compared to stressed group.

CONCLUSION: Hence, the present study provides scientific support for the positiveadaptogenic effect of E. aureum extract.

Matched MeSH terms: Leukocyte Count

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