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Objective:To study the clinical characteristics of neonatal leukemoid reaction (NLR).Methods:The newborns with NLR admitted to the neonatal intensive care unit of the Seventh Medical Center of PLA General Hospital from September 2010 to January 2022 were selected as the observation group, and the newborns without NLR, who were admitted to the Hospital at the same time and matched with gestational age and birth weight of the NLR newborns were selected as the control group at a ratio of 1∶2. The gestational age, birth weight, maternal complications, maximum leukocyte count, percentage of neutrophils, C-reactive protein, hemoglobin, platelet count, disease diagnosis and other relevant information of the newborns were recorded, and SPSS 21.0 statistical software was applied to compare the data of the two groups of newborns.Results:A total of 36 cases were in the observation group and 72 cases in the control group. Naive granulocytes were found in the peripheral blood of all patients in the observation group, and leukocyte count was higher than that of the control group [61.7 (54.2, 90.6)×10 9/L vs. 19.6 (14.2,27.3)×10 9/L], the difference was statistically significant ( P<0.001), but there was no statistically significant difference in the percentage of neutrophils, hemoglobin, platelets, and C-reactive protein between the two groups ( P>0.05). The proportion of vaginal delivery, meconium-stained amniotic fluid, and neonatal sepsis in the observation group were higher than that in the control group [69.4% (25/36) vs. 38.9% (28/72), 19.4% (7/36) vs. 5.6% (4/72), 47.2% (17/36) vs. 8.3% (6/72)], and the proportion of gestational diabetes mellitus, gestational hypertension and prenatal use of glucocorticoid was lower than that in the control group, with statistical significance ( P<0.05). There was no significant difference in the incidence of premature rupture of membranes, neonatal asphyxia, intracranial hemorrhage, pulmonary hemorrhage, bacterial meningitis, and bronchopulmonary dysplasia between the two groups ( P>0.05). Conclusions:Newborns with NLR are frequently complicated with sepsis. Early prevention and treatment of maternal comorbidities and active control of infection are important for the prevention and treatment of NLR.
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Leukemoid reaction and myeloproliferative syndrome are close mimickers and frequently pose a diagnostic dilemma, particularly when the leukocyte count is very high. Leukocyte alkaline phosphatase score frequently aids in diagnosis but may or may not be contributory, especially in differentiating chronic neutrophilic leukemia. Herein, we document a case of leukemoid reaction with extensive hyperleukocytosis in a 46-year-old female with poorly differentiated carcinoma. The tumor itself as well as the associated leukocytosis portends a poor prognosis
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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.
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Adulto , Humanos , Injúria Renal Aguda , Contagem de Células Sanguíneas , Medula Óssea , Células da Medula Óssea , Exame de Medula Óssea , Febre , Células Precursoras de Granulócitos , Hemólise , Cariótipo , Leucemia Mielogênica Crônica BCR-ABL Positiva , Leucemia Promielocítica Aguda , Reação Leucemoide , Contagem de Leucócitos , Nefrostomia Percutânea , Neutrófilos , Contagem de Plaquetas , Derrame Pleural , Reação em Cadeia da Polimerase , Edema Pulmonar , Transcrição Reversa , Sepse , Taquicardia , TretinoínaRESUMO
Although neutrophilia can manifest from various causes, it is important to be able to distinguish chronic neutrophilic leukemia (CNL) from neutrophilic leukemoid reactions (NLR). In this paper, we describe four cases of leukocytosis with neutrophilia, including one case of CNL with a T618I mutation in colony stimulating factor 3 receptor (CSF3R) and three cases of NLR associated with malignancy or sepsis, which were initially suspected as CNL. Of the three NLR cases, one was associated with ovarian cancer, one with monoclonal gammopathy of undetermined significance and one with multiple myeloma with sepsis. This study demonstrated that confirming the clonality of myeloid cells with CSF3R T618I could contribute to making an accurate differential diagnosis between CNL and NLR in patients with solid cancers or plasma cell neoplasms caused by paraneoplastic syndromes and/or infection.
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Humanos , Fatores Estimuladores de Colônias , Diagnóstico Diferencial , Leucemia Neutrofílica Crônica , Reação Leucemoide , Leucocitose , Gamopatia Monoclonal de Significância Indeterminada , Mieloma Múltiplo , Células Mieloides , Neoplasias de Plasmócitos , Neutrófilos , Neoplasias Ovarianas , Síndromes Paraneoplásicas , SepseRESUMO
We report a rare presentation of transitional cell carcinoma of kidney with paraneoplastic fever, leukemoid reaction and thrombocytosis. Description of the case highlights an unusual clinical scenario where fever, leucocytosis, pyuria and raised procalcitonin levels at presentation in a patient with transitional cell carcinoma of kidney may mislead diagnostic work up toward an infective cause (i.e. pyelonephritis). This case will guide clinician to keep a high index of suspicion, in case they encounter such a situation.
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Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm characterized by sustained neutrophilia, splenomegaly, and hypercellular bone marrow without Philadelphia chromosome. Diagnosis of CNL requires exclusion of identifiable causes of reactive neutrophilia, such as infection and tumors. Our patient presented with general weakness and weight loss. Computed tomography (CT) showed a mass in the distal rectum, which was confirmed to be an adenocarcinoma by colonoscopic biopsy. Positron emission tomography-CT showed multiple liver, bone, and lymph node metastases. Liver and lymph node biopsies revealed neutrophilic infiltration with no evidence of adenocarcinoma. The pathological findings of the bone marrow were compatible with CNL. Cytogenetic analysis revealed a normal karyotype, and molecular analysis was negative for BCR/ABL. Here, we present a 73 year-old man diagnosed with concurrent CNL and rectal cancer.
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Humanos , Adenocarcinoma , Biópsia , Medula Óssea , Análise Citogenética , Diagnóstico , Elétrons , Cariótipo , Leucemia , Leucemia Neutrofílica Crônica , Reação Leucemoide , Leucocitose , Fígado , Linfonodos , Metástase Neoplásica , Neutrófilos , Cromossomo Filadélfia , Neoplasias Retais , Reto , Esplenomegalia , Redução de PesoRESUMO
Neutrophilic leukocytosis above 50 × 10/l not involving the bone marrow, defines a leukemoid reaction (LR). Although it simulates leukemia, most of the causes are inflammatory and benign. LR has been found to be associated with malignancy which is postulated to be caused by granulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. A 50 years old woman, presented with high grade infiltrating ductal carcinoma of breast and leukocytosis (60 ×10/ cumm). After completion of MRM, the condition of neutrophilic leukocytosis subsided. After three months, total leukocyte count rose and local relapse of tumor was found. Following that wide excision was done,and the condition of leukocytosis subsided again. In this case the leukemoid reaction was a paraneoplastic reaction which can be view as a potential for prognostic marker.
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We present a case of nasopharyngeal carcinoma complicated with hyperleucocytosis. After ruling our other causes we concluded that the hyperleucocytosis was due to paraneoplastic leukemoid reaction (PLR). The overall survival was 15 months which is rare among patients with PLR
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Neoplasias NasofaríngeasRESUMO
No abstract available.
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Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias dos Ductos Biliares/complicações , Ductos Biliares Intra-Hepáticos/química , Biópsia , Colangiocarcinoma/complicações , Diagnóstico Diferencial , Febre/diagnóstico , Imuno-Histoquímica , Leucocitose/diagnóstico , Fígado/química , Abscesso Hepático Piogênico/diagnóstico , Imageamento por Ressonância Magnética , Síndromes Paraneoplásicas/diagnóstico , Valor Preditivo dos Testes , Tomografia Computadorizada Espiral , Biomarcadores Tumorais/análiseRESUMO
Leukemoid reaction is defined as leukocytosis exceeding 50,000 cells/mm3. When it occurs in a patient with a malignancy, secondary causes such as infections, drugs, hematologic diseases and hemorrhage need to be ruled out. After excluding such causes, paraneoplastic leukemoid reaction can be considered as a diagnosis of exclusion. Paraneoplastic leukemoid reactions have been described in association with lung, gastrointestinal, genitourinary and head and neck cancers. However, pancreatic cancer with leukemoid reaction has been rarely reported. We diagnosed a case of a 55-year-old Korean woman with extreme leukocytosis associated with advanced pancreatic cancer.
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Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma Ductal Pancreático/complicações , Leucócitos/citologia , Leucocitose/complicações , Imageamento por Ressonância Magnética , Neoplasias Pancreáticas/complicações , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
A leukemoid reaction is usually associated with malignancies of the lung, stomach, and thyroid. In contrast, urothelial cell carcinoma is rarely associated with leukemoid reactions, with few cases reported over the past 30 years. Here, we describe a patient with urothelial cell carcinoma who exhibited a leukemoid reaction. The patient had an elevated white blood cell count and experienced a rapid and aggressive clinical course, terminating in death. For urothelial cell carcinoma patients exhibiting a leukemoid reaction, removal of the inciting tumor is the definitive treatment. However, considering the aggressive nature of these tumors, if the patient is unsuitable for radical surgical management, palliative chemotherapy should be considered.
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Humanos , Tratamento Farmacológico , Reação Leucemoide , Contagem de Leucócitos , Pulmão , Síndromes Paraneoplásicas , Prognóstico , Estômago , Glândula TireoideRESUMO
We report a 58 year-old-man without comorbid conditions, with a history of two months of weight loss, malaise and headache. His initial laboratory analysis showed leukocytosis of 16,100/mL with 65% eosinophils and an absolute eosinophil count of 10,465/mL. Both bone marrow biopsy and aspirate showed infiltration by mature appearing eosinophils. Treatment was started with hydroxyurea, associated with prednisone without satisfactory decrease in the eosinophil count. Polymerase chain reaction showed the presence of the gene fusion product FIP1L1/PDGFRA. Imatinib therapy was initiated, resulting in a rapid and progressive reduction in the absolute eosinophil count, with normalization at the second week of treatment. The incidence of the myeloproliferative variant causing hypereosinophilic syndrome is rare. However, the dramatic response to imatinib emphasizes the need to study the presence of the fusion product FIP1L1/PDGFRA in all patients with eosinophilia of unknown etiology.
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Humanos , Masculino , Pessoa de Meia-Idade , Antineoplásicos/uso terapêutico , Benzamidas/uso terapêutico , Síndrome Hipereosinofílica/tratamento farmacológico , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , Resultado do TratamentoRESUMO
A leukemoid reaction is defined as reactive leukocytosis exceeding 50,000/mm3, with a significant increase in early neutrophil precursors, and can be a paraneoplastic manifestation of various malignant tumors. A 71-year-old male patient complained of decreased appetite, fatigue, and abdominal fullness. He had a palpable, firm liver, and laboratory investigations suggested leukemoid reaction. Liver dynamic computed tomography revealed a hypervascular mass, and an ultrasound-guided fine-needle aspiration of the mass confirmed hepatocellular carcinoma (HCC) with a sarcomatoid component. The leukocyte count of the patient had increased to 147,800/mm3, and he died 10 days after admission. This is a rare case of leukemoid reaction in a patient with sarcomatous HCC.
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Idoso , Humanos , Masculino , Biópsia por Agulha Fina , Carcinoma Hepatocelular/patologia , Reação Leucemoide/diagnóstico , Contagem de Leucócitos , Neoplasias Hepáticas/patologia , Tomografia Computadorizada por Raios XRESUMO
Paraneoplastic syndromes are common in mesotheliomas but there is no report from India. Two cases of pleural mesothelioma with paraneoplastic haematologic syndromes, one with neutrophilic leukemoid reaction and the other with thrombocytosis, are presented in this report.
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Adulto , Cisplatino/uso terapêutico , Citocinas/uso terapêutico , Humanos , Índia , Imageamento por Ressonância Magnética , Masculino , Síndromes Paraneoplásicas/sangue , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/tratamento farmacológico , Tumor Fibroso Solitário Pleural/diagnóstico , Tumor Fibroso Solitário Pleural/tratamento farmacológico , Trombocitose/diagnóstico , Trombocitose/tratamento farmacológicoRESUMO
PURPOSE:Leukemoid reaction (LR) represents inflammatory reaction in very low birth weight (VLBW) infants, and has been reported to relate with the development of bronchopulmonary dysplasia (BPD). This study was done to assess the relationship between perinatal characteristics and neonatal outcome of leukemoid reaction in VLBW infants. METHODS:Three hundred and seventy two VLBW infants admitted to the NICUs of SNUCH and SNUBH between June 2005 to June 2008 were studied in a retrospective case-controlled manner. Of these VLBW infants, 32 LR (+) infants were compared with 83 LR (-) infants who were matched for gestational age and birth weight with respect to perinatal and neonatal clinical characteristics. LR was defined as a white blood cell (WBC) count of more than 40,000 cells/mm3 or absolute neutrophil count of more than 30.000 cells/mm3 during the first month of life. RESULTS:Of 413 VLBW infants, There was no significant difference between the LR (+) and LR (-) infants in sex, Apgar scores, maternal peripheral WBC count, the use of antenatal steroids and maternal age. Comparing with LR (-) infants, LR (+) infants had a higher positive rate for amniotic fluid culture (67% vs 11%; P< or =0.01), U. ureaplasma in amniotic fluid (52% vs 10%; P=0.01), histologic chorioamnionitis (81% vs 33%; P=0.01) and funisitis (50% vs 7%; P=0.01). The incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, sepsis, intraventricular hemorrhage and BPD showed no significant difference between LR (+) and LR (-) infants. CONCLUSION:LR during the first month of life in VLBW infants was associated with chorioamnionitis, but not with the incidence of bronchopulmonary dysplasia or other neonatal morbidities. These findings suggest that LR may be a simple reflection of transient accelerated neutrophil production induced by prenatal inflammation without significant neonatal consequences.
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Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Líquido Amniótico , Peso ao Nascer , Displasia Broncopulmonar , Estudos de Casos e Controles , Corioamnionite , Permeabilidade do Canal Arterial , Enterocolite Necrosante , Idade Gestacional , Hemorragia , Incidência , Recém-Nascido de muito Baixo Peso , Inflamação , Reação Leucemoide , Leucócitos , Idade Materna , Neutrófilos , Ácidos Polimetacrílicos , Estudos Retrospectivos , Sepse , Esteroides , UreaplasmaRESUMO
PURPOSE: This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages 30,000/mm3. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. RESULTS: Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. CONCLUSION: Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.
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Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Índice de Apgar , Peso ao Nascer , Displasia Broncopulmonar , Proteína C-Reativa , Corioamnionite , Permeabilidade do Canal Arterial , Enterocolite Necrosante , Idade Gestacional , Hemorragia , Incidência , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Inflamação , Terapia Intensiva Neonatal , Reação Leucemoide , Prontuários Médicos , Mães , Neutrófilos , Parto , Prognóstico , Retinopatia da Prematuridade , Estudos Retrospectivos , Esteroides , Ventiladores MecânicosRESUMO
Pseudomembranous colitis (PMC) is highly prevalent in patients with broad spectrum antibiotic therapy. It can result in significant morbidity and mortality, especially if it is not diagnosed early. The clinical manifestation of PMC is diverse and symptoms usually are increased order of severity. Although leukocytosis is common, leukemoid reaction is very rare in PMC. We report a case of PMC associated with a leukemoid reaction without typical symptoms in a type 2 diabetic patient who have the multiple diabetic complications.
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Humanos , Clostridioides difficile , Complicações do Diabetes , Diabetes Mellitus , Enterocolite Pseudomembranosa , Reação Leucemoide , Leucocitose , MortalidadeRESUMO
Renal cell carcinoma has been recognized for several years as a relatively common cause of paraneoplastic syndromes. Fever, polycythemia, hypercalcemia, amyloidosis, abnormal liver function, Cushing's syndrome and neuropathy have been ostm frequently reported in association with renal cell carcinoma, but leukemoid reactions have been reported only rarely with this tumor. Recently we experienced a leukemoid reaction in a 64-year old female patient who presented with an advanced case of renal cell carcinoma. According to the literature the mortality is 100% with leukemoid reactions in renal cell carcinoma, and indeed this patient expired. We therefore, consider this reaction as a late manifestation of a bizzare presentation of renal cell carcinoma.
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Feminino , Humanos , Pessoa de Meia-Idade , Amiloidose , Carcinoma de Células Renais , Síndrome de Cushing , Febre , Hipercalcemia , Reação Leucemoide , Fígado , Mortalidade , Síndromes Paraneoplásicas , PolicitemiaRESUMO
Leukemoid reactions often are seen in patients with underlying malignancies, but they have been reported infrequently in patients with urologic malignancies. We report leukemoid reaction in a patient with renal cell carcinoma. The hematological abnormality had not resolved with definite surgical and hormonal therapies for the underlying renal cell carcinoma.