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Laboratory Medicine Online ; : 26-29, 2019.
Artículo en Coreano | WPRIM | ID: wpr-719664

RESUMEN

Neutrophilic leukemoid reaction may occur in many situations, including hemolysis, malignancy, infection, and exposure to certain toxins. It usually shows morphological overlap with chronic myeloid leukemia in which promyelocytes are not majorly associated. Here, we present a case of promyelocytic leukemoid reaction in a patient with sepsis. A 28-year-old man was admitted for renal stone removal. After percutaneous nephrolithotomy, his condition deteriorated with fever (37.8℃), tachycardia (130/min), acute renal failure, pleural effusion, and pulmonary edema. Complete blood count indicated a white blood cell count of 73.39×10⁹/L including 82% promyelocytes, hemoglobin 8.9 g/dL, and platelet count of 85×10⁹/L. A bone marrow aspirate showed that promyelocytes accounted for 73.8% of all nucleated cells. Following bone marrow examination, treatment with all-trans retinoic acid (ATRA) was started immediately. Reverse transcription polymerase chain reaction (RT-PCR) study revealed the absence of PML-RARA (promyelocytic leukemia-retinoic acid receptor alpha) and other RARA (retinoic acid receptor alpha) rearrangements. Once the chromosome analysis of bone marrow cells demonstrated the normal karyotype, ATRA was discontinued.


Asunto(s)
Adulto , Humanos , Lesión Renal Aguda , Recuento de Células Sanguíneas , Médula Ósea , Células de la Médula Ósea , Examen de la Médula Ósea , Fiebre , Células Precursoras de Granulocitos , Hemólisis , Cariotipo , Leucemia Mielógena Crónica BCR-ABL Positiva , Leucemia Promielocítica Aguda , Reacción Leucemoide , Recuento de Leucocitos , Nefrostomía Percutánea , Neutrófilos , Recuento de Plaquetas , Derrame Pleural , Reacción en Cadena de la Polimerasa , Edema Pulmonar , Transcripción Reversa , Sepsis , Taquicardia , Tretinoina
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