CLINICAL IMMUNOLOGY AND SEROLOGY STEVENS PDF
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Clinical immunology and serology: a laboratory perspective / Christine Dorresteyn Stevens. — 3rd ed. p. ; cm. Includes bibliographical references and index. online in rar, word, pdf, txt, kindle, zip, and ppt. clinical immunology serology stevens 3rd edition download or read: clinical immunology serology stevens 3rd . Save this PDF Ebook to Read clinical immunology serology stevens 3rd edition PDF eBook at our Collection. Get clinical immunology serology stevens 3rd.
This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: Christa Fratantoro Manager of Content Development: George W.
Lang Developmental Editor: The author s and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author s , editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation.
The reader is advised always to check product information package inserts for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Clinical immunology and serology: Includes bibliographical references and index.
ISBN 1. Immunodiagnosis—Laboratory manuals. Serodiagnosis—Laboratory manuals. Clinical immunology. Immune System Diseases—diagnosis. Immunologic Techniques. Immunologic Tests. Serologic Tests. QW Sc ] RB S73 For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: The third edition of Clinical Immunology and Serology: A Laboratory Perspective is built on the success of the first two editions.
This text is tailored to meet the needs of clinical laboratory students on both the two and four year levels. It combines practical information about laboratory testing with a concise discussion of the theory behind the testing.
All chapters have been updated to include new information about the immune system as well as new treatments for immunological diseases. Two new chapters have been added. They include: The chapter on fungal and parasitic infections has been expanded Chapter 20 , as well as the chapter on molecular techniques Chapter All the features that readers enjoyed have been retained and strengthened. The number of illustrations has increased, and new case studies have been added.
The book remains a practical introduction to the field of clinical immunology that combines essential theoretic principles with serologic techniques commonly used in the clinical laboratory. The theory is comprehensive but concise, and the emphasis is on direct application to the clinical laboratory.
The text is readable and user-friendly, with. The organization of the chapters is based on the experience of many years of teaching immunology to clinical laboratory science students. This book has been designed to provide the necessary balance of theory with practical application because it is essential for the practitioner to have a thorough understanding of the theoretic basis for testing methodologies.
For the instructor, suggested laboratory exercises are included where applicable.
While some of the exercises are not used in an actual clinical laboratory, they serve to illustrate and reinforce principles discussed in the chapters. Since most clinical laboratory science programs do not have extensive technology available in the academic setting, exercises have been designed to be performed with minimal equipment. Because the field of immunology is expanding so rapidly, the challenge in writing this book has been to ensure adequate coverage but to keep it on an introductory level.
Every chapter has been revised to include current practices as of the time of writing. Immunologist Dept. Dorothy J. Marc G. Susan M. John L. Patsy C. Kentucky Karen Jean McClure. Reviewers Hassan Aziz. Kansas ix. DC Kathy Heidrick.
Massachusetts Maribeth Laude Flaws. Texas Phyllis Gutowski. Pennsylvania Abraham Furman. Oklahoma Marguerite E. Delaware Karen A. Illinois Kay Harris. Connecticut Wendy Miller. Tom Alexander. I would also like to thank the reviewers whose additional sets of eyes and thoughtful suggestions helped to strengthen the chapters. My hope is that this text will help make a very complex subject a little easier to understand.
Candace Golightly. Donald Lehman. My other contributors. I appreciate and learn as much or more from your curiosity and your questioning as you do from me. Tim Stegall. George Lang. Susan Orton.
John Schmitz. Christa Fratantoro. A special thank you to Linda Miller. Dorothy Fike. Marc Golightly. Marsha Hall. Finally I would like to acknowledge all the folks at F. Patsy Jarreau. Diane Davis. My immunology students. Acknowledgments I am grateful for the assistance I received from a number of sources during the preparation of this third edition.
A thank you to friends whose encouragement and understanding helped me to stay on task. Davis for their hard work in making this third edition a reality. David Orzechowski. Nature of the Immune System 1 Chapter 1: Contents Color Plates follow p. Safety and Specimen Preparation Chapter 5: Orton Characteristics of Nucleic Acids Chapter 9: Immune Disorders Chapter Schmitz Introduction Histocompatibility Systems Chapter Transplantation Immunology Chapter Spirochete Diseases Marc Golightly.
Tumor Immunology Diane L. Serological Diagnosis of Infectious Disease Chapter FA Davis. Photo of a mast cell. See Figure 2—1 in the text. Photo of a basophil. Typical lymphocyte found in peripheral blood. Clinical Hematology and Fundamentals of Hemostasis. See Figure 1—4 in the text. Color Plate See Figure 1—5 in the text. See Figure 1—2 in the text. See Figure 1—1 in the text. Photo of Neutrophils. From Harmening. Clinical Laboratory Science Review. See Figure 1—3 in the text. Photo of two monocytes.
From Harr. Photo of an eosinophil. Immunofixation electrophoresis. Courtesy of Helena Laboratories. Direct fluorescent antibody test for Giardia and Cryptosporidium in stool. See Figure 8—7 in the text. See Figure in the text. Immunoelectrophoresis film showing normal controls odd-numbered wells and patient serum even-numbered wells.
See Figure 8—8 in the text. A typical plasma cell. Larger oval bodies are Giardia lamblia cysts. Courtesy of DiaSorin. See Figure 14—2 in the text. See Figure 2—8 in the text. Patterns of immunofluorescent staining for antinuclear antibodies. Courtesy of Meridian Bioscience. Color Plate 4. Four different patient immunofixation patterns. R and Cheadle. See Figure Medical Parasitology: A Self-Instructional Text. See Figure 17—2 in the text.
Pseudocyst of Toxoplasma gondii seen in a brain section. Agarose gel immunofixation electrophoresis of serum. From Leventhal. Discuss how immunology as a science began with the study of immunity.
Discuss the intracellular mechanism for destruction of foreign particles during the process of phagocytosis. Explain what an antibody is. Discuss the role of acute-phase reactants in the innate or natural immune response. Recognize false-positive and false-negative reactions in the latex agglutination test for C-reactive protein. Differentiate between the external and internal defense systems. Distinguish natural from acquired immunity.
Explain the importance of phagocytosis in both natural and acquired immunity. Describe the types of white blood cells capable of phagocytosis.
List the steps in the process of phagocytosis. He called this process phagocytosis. Virtually the entire history of immunology has been recorded within the last years. In Immunology as a science has its roots in the study of immunity.
Louis Pasteur. The theory of humoral immunity was thus born. It was not until the s that the cells responsible for the immune response were identified and characterized. A foreign substance that induces such an immune response is called an antigen. Pasteur applied this same principle of attenuation to the prevention of rabies. These discoveries have impacted testing in every area of the laboratory and have played a significant role in the diagnosis and treatment of disease.
The theory was that if a healthy individual was exposed as a child or young adult. After observing the fact that milkmaids who were exposed to cowpox had apparent immunity to smallpox. Although he did not know the causative agent. The boy received a series of 12 injections beginning with material from the least infectious cords and progressing to the fresher.
He noted that spinal cords left to dry for a few days were less infectious to laboratory animals than fresh spinal cords. Other researchers contended that noncellular elements in the blood were responsible for protection from microorganisms. This practice of deliberately exposing an individual to material from smallpox lesions was known as variolation. Within 50 years of this discovery.
Pasteur tried out his new procedure. At the same time. This procedure of injecting cellular material became known as vaccination. He thus proved that immunity to cowpox.
In this manner. The external defense system is designed to keep microorganisms from entering the body. In the digestive tract. Phagocytosis is enhanced by soluble factors called acutephase reactants.
If these defenses are overcome. This phenomenon is known as competitive exclusion. Both of these systems work together to promote phagocytosis. The natural defense system is composed of two parts: If the healing process is begun and resolved as quickly as possible. Lactic acid in sweat. Lysozyme is an enzyme found in many secretions such as tears and saliva.
Both systems are essential to maintain good health. Acquired immunity. Lactic acid production in the female genital tract keeps the vagina at a pH of about 5. He observed that certain humoral. This acid pH keeps most microorganisms from growing. To understand how important a role these play. These are considered nonadaptive or nonspecific and are the same for all pathogens or foreign substances to which one is exposed. Acute-Phase Reactants Acute-phase reactants are normal serum constituents that increase rapidly by at least 25 percent due to infection.
The internal defense system is designed to recognize molecules that are unique to infectious organisms.
This chapter will consider the branch of immunity know as natural immunity. First and foremost is the unbroken skin and the mucosal membrane surfaces. White blood cells seek out and destroy foreign cells by participating in phagocytosis. Not only does the skin serve as a major structural barrier.
In the respiratory tract. Many of these mechanisms are subject to influence by such factors as nutrition. No prior exposure is required. The flushing action of urine.
Internal defenses can be categorized into cellular mechanisms and humoral factors. In many locations of the body. This process destroys most of the foreign invaders that enter the body. These cell messengers. It is an apolipoprotein that is synthesized in the liver and has a molecular weight of The median CRP value for an individual increases with age. It is a member of the family known as the pentraxins.
High-sensitivity CRP testing has a lower level of detection of 0. CRP has a plasma half-life of about 19 hours. CRP is the most widely used indicator of acute inflammation.
Levels increase dramatically as much as a hundredfold to a thousandfold. CRP acts somewhat like an antibody. Because the levels rise and then decline so rapidly.
In plasma. CRP can be thought of as a primitive. In accord with the finding that atherosclerosis. It increases rapidly within 4 to 6 hours following infection. It also binds to small ribonuclear proteins. It is able to recognize foreign carbohydrates such as mannose and several other sugars found primarily on bacteria.
There are nine such proteins that are activated by bound antibodies in a sequence known as the classical cascade. It has been estimated that as many as Lack of MBP has been associated with recurrent yeast infections. This increases the strength of a wound and stimulates endothelial cell adhesion and proliferation. Its primary function is to bind irreversibly to free hemoglobin released by intravascular hemolysis. Haptoglobin Haptoglobin is an alpha2-globulin with a molecular weight of The major functions of complement are opsonization.
This may serve as a means of releasing iron from ferritin for binding to transferrin. Complement is discussed more fully in Chapter 6. It also regulates expression of proinflammatory cytokines such as tumor necrosis factor-alpha.
Fibrinogen also serves to promote aggregation of red blood cells. Alpha1-antitrypsin deficiency can result in premature emphysema. Once bound to alpha1antitrypsin. Fibrinogen Fibrinogen is the most abundant of the coagulation factors in plasma.
Once bound. Although the name implies that it acts against trypsin. It has many similarities to the complement component C1q. See Color Plate 1. Eosinophils take up the acid eosin dye. Several cell lines that are found in the tissues. Each of these cell types is described in this chapter. Once in the tissues. Primary granules. Their number increases in an allergic reaction or in response to many parasitic infections. Marginating occurs to allow neutrophils to move from the circulating blood to the tissues through a process known as diapedesis.
These can be further divided into granulocytes and monocytes. They contain a large number of neutral staining granules. Some of these white blood cells participate in the process of phagocytosis. The nucleus is usually bilobed or ellipsoidal and is often eccentrically located Fig.
Chemotaxins are chemical messengers that cause cells to migrate in a particular direction. Neutrophils The neutrophil. Photo of neutrophils. There is a continuous interchange. Factors that are chemotactic for neutrophils include complement components.
See Color Plate 2. Lymphocytes form the basis of the acquired immune response and are discussed in Chapter 2. They are attracted to a specific area by chemotactic factors.
Receptors known as selectins help make neutrophils sticky and enhance adherence to endothelial cells that make up the vessel wall. Unlike basophils. These make up between 4 and 10 percent of total circulating white blood cells.
The smallest of the granulocytes. See Color Plate 4. The granules lack hydrolytic enzymes. These granules are actually of two types. Digestive vacuoles may also be observed in the cytoplasm. Basophils Basophils are found in very small numbers. See Color Plate 5. Constituents of these granules are histamine. They stay in peripheral blood for up to 70 hours. Mast Cells Tissue mast cells resemble basophils. Basophils exist for only a few hours in the bloodstream.
Monocytes Monocytes. See Color Plate 3. Phagocytosis The process of phagocytosis consists of four main steps: This process is aided by chemotaxis. Very similar molecules are found on human leukocytes and some nonleukocyte cell types. After capturing antigen in the tissue by phagocytosis or endocytosis. Toll-like Receptors While each of the aforementioned cells has its own unique receptors to attach to microorganisms. Toll-like receptors on a white cell membrane. They are classified according to their tissue location.
The highest concentration of these receptors occurs on monocytes. Unlike monocytes. Macrophages in the lung are alveolar macrophages. TLR4 recognizes lipopolysaccharide in gram-negative bacteria. A few examples are shown here. See Chapter 5 for a complete discussion of cytokines.
For example. Dendritic Cells Dendritic cells are so named because they are covered with long membranous extensions that make them resemble nerve cell dendrites.
Their main function is to phagocytose antigen and present it to helper T lymphocytes. Once a receptor binds to its particular substance. Physical contact occurs as neutrophils roll along until they encounter the site of injury or infection. Receptors on neutrophils or monocytes come into contact with the foreign particle surface.
Some are immobile. Kupffer cells. While their actual developmental lineage is not known. Langerhans cells are found on skin and mucous membranes. TLR1 recognizes lipoprotein found in mycobacteria. They are the most potent phagocytic cell in the tissue. Each of the 11 different Toll-like receptors recognizes a different pathogenic product. The monocyte—macrophage system plays an important role in initiating and regulating the immune response.
TLR2 recognizes teichoic acid and peptidoglycan found in gram-positive bacteria. TLR2 binds to peptidoglycan in gram-positive bacteria. Their functions include microbial killing.
This is accomplished through the action of the enzyme myeloperoxidase in the presence of chloride ions. Creation of oxygen radicals in the phagocytic cell.
Its effect is potentiated by the formation of hypochlorite ions. D Formation of the phagolysome: Superoxide is converted to hydrogen peroxide through the action of the enzyme superoxide dismutase.
The hexose monophosphate shunt is used to change nicotinamide adenine dinucleotide phosphate NADP to its reduced form by adding a hydrogen. The phagosome is gradually moved toward the center of the cell. The actual process of killing is oxygen-dependent and results from the generation of bactericidal metabolites.
A Adherence: Opsonins may act by neutralizing the surface charge on the foreign particle. F Excretion of contents of phagolysosome to the outside by exocytosis. Phagocytic cells have receptors for immunoglobulins and for complement components. C-reactive protein. Myeloperoxidase catalyzes formation of the hypochlorite radical. C Formation of phagosome: E Digestion of the microorganism by hydrolytic enzymes. Steps involved in phagocytosis. Patients with this disease suffer from recurring.
Any undigested material is excreted from the cells by exocytosis. Heavily opsonized particles are taken up in as little as 20 seconds. Once attachment has occurred. Hydroxyl radicals.
An increase in oxygen consumption. Hypochlorite ions are powerful oxidizing agents. By adding hydrogen ions. When hydrogen combines with the superoxides. At this point. Inflammation The overall reaction of the body to injury or invasion by an infectious agent is known as inflammation. NADPH oxidase is known to be central to the killing of microbes. Superoxide is highly toxic but can be rapidly converted to more lethal products. The structure formed is known as a phagosome. Hydrogen peroxide has long been considered an important bactericidal agent.
B Outflowing of cytoplasm to surround the microorganism. All of these substances contribute to killing within the phagocyte Fig. The granules then release their contents.
Both cellular and humoral mechanisms are involved in this complex. The controversy over cellular versus humoral immunity was responsible for spawning much important research in the early years. Each individual reactant plays a role in initiating. Macrophages in the tissue are directed to the area. Elie Metchnikoff identified phagocytic cells as a part of cellular immunity. Macrophages attempt to clear the area through phagocytosis. Neutrophil emigration may last 24 to 48 hours and is proportional to the level of chemotactic factors present in the area.
Acute-phase reactants stimulate phagocytosis of microorganisms. Soluble mediators. They are attracted to the site of injury or infection by the chemotaxins mentioned previously.
The four cardinal signs or clinical symptoms are redness. Another well-known name in the early history of immunology is Louis Pasteur. Events in the inflammatory response. As the endothelial cells of the vessels contract. Increased blood supply to the affected area is followed by increased capillary permeability and migration of neutrophils and macrophages to the tissues. Both of these theories were brought together by Almuth Wright.
Clinical signs at the site of inflammation include edema and erythema. Chemical mediators such as histamine. Edward Jenner. Tissue healing. This process destroys most of the foreign cells that penetrate the external defenses. Internal defenses are centered on the process of phagocytosis. They enhance the process of phagocytosis by attracting leukocytes to the area of injury and by coating the foreign material so that it can be ingested more easily.
Cells that are most active in phagocytosis include neutrophils. The process is oxygen-dependent. Other functions of the acute-phase reactants include neutralization of mediators and proteolytic enzymes generated during the process of responding to pathogens. Physical contact between the phagocytic cell and the foreign particle is aided by chemotaxis.
These are always present. Inside this structure. Fusion of the phagosome with lysosomal granules creates a phagolysosome.
External defenses are structural barriers such as skin. Acute-phase reactants are serum constituents that increase rapidly in response to infection or injury to the tissues. Once contact occurs. A slide agglutination test for infectious mononucleosis was indeterminate. His physical examination was perfectly normal. A year-old male named Rick went to his physician for an annual checkup.
How does a test result showing an increase in CRP help in a presumptive diagnosis of infectious mononucleosis? Who is correct? Explain your answer. A complete blood count was performed.
The student was advised to return in a few days for a repeat mono test. Although he was slightly overweight. A rapid strep test was performed.
The physician cautioned Rick that he might be at risk for a future heart attack. Wright Stain 1.
Clinical Immunology and Serology: A Laboratory Perspective
Note that blood drawn in an EDTA tube within the last 10 minutes can also be used. Shake the tubes to mix. There should be a noticeable difference between the 0. Neutrophils will be the predominant phagocytic cells. Comments These blood smears will be more watery than usual due to the addition of the broth culture with bacteria.
Add one drop of Staphylococcus epidermidis culture to each tube. Use immersion oil and look for engulfment. Allow the blood smear to air dry.
[PDF] Clinical Immunology and Serology: A Laboratory Perspective (Clinical Immunology and Serology
The culture should be no more than a 0. Keeping the spreader slide at a degree angle. Stain according to typical laboratory protocol for staining blood smears.
Method for Making Blood Smears 1. As soon as the slide comes in contact with the drop of blood. Materials Test tubes. Let the other tubes incubate for 5 minutes and 10 minutes.
Move the spreader slide back toward the drop of blood. Using a black rubber bulb. If there is enough blood available. There should be a feathered edge on the end of the smear.
Blot the back of the slides to remove excess stain and let them air dry. With a Pasteur pipette. The feathered edge is not essential. Obtain two clean glass slides. The 0-minute slide will probably not show much engulfment.
If lymphocytes are the only white blood cell seen. Dilute in an additional broth tube or in sterile saline if necessary. The 5-minute slide should show bacteria within the cell as small purple dots. Perform a slide agglutination test on each dilution by repeating the procedure steps 3 through 7 as above.
An explosion may occur upon percussion. Add 0. If a calibrated pipetter is used instead of the pipettes provided. Using the squeeze-dropper vials provided. Fresh nonheat inactivated serum is recommended for the test. A positive and a negative control should be run with each test. If CRP is present above normal threshold levels. If the reagent fails to agglutinate with the positive control.
An elevated CRP level is a sensitive. Begin with a 1: Flush drains thoroughly with water after disposing of fluids containing sodium azide. Tilt the slide back and forth. While holding the pipette perpendicular to the slide.
Specimen Collection Collect blood aseptically by venipuncture into a clean. Semiquantitative Slide Test 1. Be sure reagents and specimens are at room temperature. Using one of the pipettes provided. If a positive reaction is obtained. Separate the serum without transferring any cellular elements. Sodium azide may form lead or copper azide in laboratory plumbing. In this case. Continue until all tubes are diluted.
If there is any additional delay. The human serum used in the preparation of controls is tested by an FDA-approved method for the presence of antibodies to HIV as well as for hepatitis B surface antigen and HCV and found to be negative. Blend the tube contents thoroughly. Place one drop of CRP latex reagent next to each serum specimen and to each control.
Do not use grossly hemolyzed. Using separate stirrers. The CRP positive control serum must show distinct agglutination. Resuspend the latex reagent by gently mixing the vial until the suspension is homogeneous. Reagents in the kit contain sodium azide as a preservative.
False-positive reactions may occur with a reaction time longer than 2 minutes or with specimens that are lipemic. CRP levels can be used to monitor the outcome of surgery. False-negative reactions may be due to high levels of CRP in undiluted specimens. Reagent and control should not be used after the expiration date indicated on the outside kit label. A level of 0.
Discard buffer if contaminated evidence of cloudiness or particulate material in solution. Remel Incorporated. Normal levels range from 0. CRP levels rise sharply and usually peak between 48 and 72 hours. Package insert. Sodium azide may react with lead and copper plumbing to form highly explosive metal azides. Do not use the CRP reagent if there is evidence of freezing. In most situations. The titer is represented by the last dilution that shows a positive reaction. On disposal.
A negative reaction is characterized by a lack of visible agglutination in the undiluted specimen. For patients with rheumatoid arthritis. A positive reaction is reported when the specimen shows 1.
KS CRP testing can also be used to monitor graft rejection. Following surgery. Which is the most significant agent formed in the phagolysosome for the killing of microorganisms?
Eosinophils 5. Competing with pathogens for nutrients c. Hydrogen peroxide d. Which of the following white blood cells is capable of further differentiation in the tissues? What should the technologist do next? Hydroxyl radicals c. Which of the following plays an important role as an external defense mechanism? A latex agglutination test for CRP is run on a yearold girl who has been ill for the past 5 days with an undiagnosed disease.
Only the antibody triggers the complement cascade. Eosinophil c. Lymphocytes d. CRP acts before the antibody appears. Enhancement of phagocytosis by coating of foreign particles with serum proteins is called a. Phagocytosis b. Monocytes c. Monocyte Only CRP acts as an opsonin.
Auto 8. All of the above Superoxides Neutrophil b. Adaptive d. Natural immunity b. Basophil d. The process of inflammation is characterized by all of the following except a.
Report the result as positive d. The action of CRP can be distinguished from that of an antibody in which of the following ways? Obtain a new sample Natural b.
C-reactive protein c. Keeping phagocytes in the area d. Neutrophils b. Repeat the entire test b. Acquired c. Proteolytic enzymes b. Complement 6. Cross-immunity 3. Enhancement of phagocytosis c.
Which of the following peripheral blood cells plays a key role in killing of parasites? Book is not very well written. I am just in my first year of MLT classes and the book expects you to know all these terms that you havent learned yet. It is very hard reading if you dont already have a science back round. This book should definately be for 2nd year students There are only the slightest differences between this edition and the current edition. I followed along in the class just fine.
The wording was basically the same just maybe 5 to 10 pages difference in page numbers. If you have to purchase this book because it is MANDATED i would most definately suggest this book, it will aave you a lot of money,just be ready to have some sort of medical dictionary on hand to follow along.
Its just OK This book helps me study but is not organized nicely, especially with bold info. I find it easier to look terms up online for clarification than to read the roundabout mess in the book. It saves me a lot of time when making my study guides to 1' use the web and 2' use the book. Sometimes the diagrams explain things better than an entire page. I wish my teacher picked a better book, bottom line. Most texts books I read through each chapter.
I tried that with this book and I felt like I accomplished little. The way the book is worded leaves a lot to be desired. One person found this helpful. I needed this book for my MLT immunology class.
It is a good resource but very scientificly wordy. There is a lot of information aimed at a higher level of education than the program that I was taking. Lots of things to look forward to as I progress in my understanding of immunological things.
Clinical Immunology and Serology is very helpful and explanatory. I am very happy with the content of the book and it has made understanding Immunology easier.
This book is very technical and somewhat hard to understand but I needed it for class. My teacher also did not like this book and is no longer going to use this one because it is very technical and hard to understand. See all 29 reviews. Amazon Giveaway allows you to run promotional giveaways in order to create buzz, reward your audience, and attract new followers and customers.
Review In Clinical Immunology & Serology
Learn more about Amazon Giveaway. This item: Set up a giveaway. Customers who viewed this item also viewed. A Laboratory Perspective. Christine Dorresteyn. Mary Louise Turgeon. Kathy D. Blaney MS. Pages with related products. See and discover other items: There's a problem loading this menu right now. Learn more about Amazon Prime. Get fast, free shipping with Amazon Prime. Back to top. Get to Know Us. Amazon Payment Products. English Choose a language for shopping.
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Clinical Immunology and Serology Stevens Paperback: Allow the blood smear to air dry. C-reactive protein. Once lymphocytes mature in the primary organs. T-cell rosette. All lymphocytes arise from pluripotential hematopoietic stem cells that appear initially in the yolk sac of the developing embryo and are later found in the fetal liver. A foreign substance that induces such an immune response is called an antigen.
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