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Results for “Leukemoid Reaction”

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PubMed1978

Host genetic factors influencing the occurrence of leukemoid reaction in BALB/cMk mice bearing transplanted tumors.

Host genetic factors influencing the occurrence of leukemoid reaction in BALB/cMk strain mice bearing transplanted tumors were studied. A Mendelian hybridization experiment was performed with BALB/cMk and C57BL/6 strains, and their strain hybrids; the first filial (F1) generation hybrids; the second filial (F2) generation hybrids; and the backcrosses to the two parental strains. The results of these studies suggested a genetic regulation of leukemoid reaction occurrence in BALB/cMk mice bearing transplanted tumors. Genes permissive to the occurrence of the reaction seemed to be dominant to their nonpermissive alleles.

Animals↗
PubMed1982

Neonatal leukemoid reaction. An isolated manifestation of mosaic trisomy 21.

A phenotypically normal neonate with an unexplained leukemoid reaction had a 46,XX/47,XX, +21 karyotype limited to the hemopoietic system. Although a self-limited myeloproliferative syndrome occurs in Down's syndrome, this case confirms that an identical disorder may develop in patients with mosaic trisomy 21 and no phenotypic stigmas of Down's syndrome. Chromosome analysis is a necessary adjunct to the examination of any neonate with an unexplained leukemoid reaction. The presence of trisomy 21 should lead to conservative management, unless there is life-threatening progression of the disease.

Down Syndrome↗
PubMed2004

Leukemoid reaction: a diagnostic clue in metastatic carcinoma mimicking classic Hodgkin lymphoma.

We report on 2 patients who were initially suspected to have classic Hodgkin lymphoma because of lymphadenopathy and the presence of Reed-Sternberg-like cells. Both patients had an associated leukemoid reaction (using a threshold leukocyte count of 50 000/microL) and were eventually diagnosed with metastatic carcinoma. Disseminated carcinoma can mimic Hodgkin lymphoma clinically, radiologically, and histologically. Reed-Sternberg-like cells may be found in carcinomas, and they represent a particularly challenging diagnostic pitfall for the unwary. When these cells lead to a suspicion of Hodgkin lymphoma, the presence of a leukemoid reaction should prompt the pathologist to question the diagnosis. Misdiagnosis can be avoided by the use of cytokeratin whenever a leukemoid reaction is present in a suspected case of Hodgkin lymphoma.

Adrenal Gland Neoplasms↗
PubMed1994

Leukemoid reaction in a child with appendiceal abscess: a case report.

A case of appendiceal abscess presenting leukemoid reaction is reported. A seven-month-old male infant was admitted because of fever and diarrhea. Anemic conjunctiva and mild abdominal distension were the only physical findings on arrival. Progressive leukocytosis with left shift maturation was noted during hospitalization. The maximal white blood cell count was 178,000/cumm, with a high leukocyte alkaline phosphatase score. On the fourth day of admission, a palpable right lower quadrant abdominal mass with local tenderness was found. Appendiceal abscess was diagnosed by both ultrasonography and computed tomography. The infant received triple antibiotic therapy consisting of ampicillin, gentamicin, and clindamycin for 10 days; the mass disappeared two weeks later. As appendiceal abscess is a rare occurrence in infants and its production of a leukemoid reaction is even rarer, the case described here may cause a diagnostic challenge, and deserves attention from clinicians.

Abscess↗
PubMed1994

Karyotype evolution in a patient with Down syndrome and acute leukemia following a congenital leukemoid reaction.

We report the serial cytogenetic study of a patient with Down syndrome who experienced a congenital leukemoid reaction, underwent a spontaneous remission within four months, and subsequently developed acute myeloid leukemia at 16 months. A blood chromosome study to rule out Down syndrome performed at age 24 days, during the leukemoid reaction, revealed a 47,XX,+21 karyotype. The diagnosis of acute leukemia was made at 16 months, at which time a chromosome study, on bone marrow, was performed. This analysis revealed a clonal karyotype of 47,XX,+21,-22,+der(22)t(1;22)(q21;q13) in all but one cell studied. The single apparently nonclonal cell showed a karyotype of 49,XX,+12,-13,-19,+der(19)t(19;?)(q11;?)x2,+21,+22. A third chromosome study at 19 months indicated the original leukemic clone with t(1;22) (q21;q13) had been replaced by the clone represented by the single cell with 49 chromosomes seen in the previous chromosome study. This case of an infant with Down syndrome and acute leukemia illustrated rapid evolution and a transitory nature to clonal chromosome aberrations while retaining AML morphology and course.

Acute Disease↗
PubMed1986

Leukemoid reaction associated with severe diabetic ketoacidosis.

A 30-year-old man had severe diabetic ketoacidosis and a leukemoid reaction, which promptly resolved after therapy with intravenous fluids and insulin. There was no evidence of an underlying malignancy or infection. Although a mild leukocytosis may accompany DKA, a leukemoid reaction has not been previously reported to occur with uncomplicated diabetic ketoacidosis.

Acute Disease↗
PubMedDate not supplied

Suspected betamethasone-induced leukemoid reaction in a premature infant.

The use of antenatal corticosteroids in threatened pregnancies of less than 34 weeks' duration is a valuable tool for assisting fetal lung maturation. Although this practice has existed for over 20 years, little is known about a rare extreme elevation of the newborn's white blood cell count, called a leukemoid reaction. A case of leukemoid reaction is discussed to assist the clinician with the current thought processes and diagnostic differential behind this benign condition.

Adult↗
PubMedDate not supplied

[Priapism following paraneoplastic leukemoid reaction in a patient with bladder cancer].

Priapism associated with solid tumours is usually produced by penile metastasis or direct tumour infiltration of the corpora cavernosa. Neoplasias are responsible for between 3-8% of all cases of priapism, and in 80% of cases the primary tumour has a genito-urinary origin. Leukemoid reaction is an haematological disorder characterised by a leukocytosis of over 50000/microl, which develops reactively with different pathological processes such as severe inflammation, disseminated infections, intoxications and tumours. The pathophysiologic mechanism that explains priapism following leukemoid reaction is an intravascular obstruction due to blood hyperviscosity, leading to a blood stasis in the cavernosa veins, and impeding the drainage of the corpora cavernosa. We present a case of priapism in a patient with locally advanced bladder cancer, which was probably the result of blood hyperviscosity produced by a paraneoplastic leukemoid reaction.

Aged↗
PubMed2004

Leukemoid reaction due to Clostridium dificile infection in acquired immunodeficiency syndrome: two case reports and a review of the literature.

The clinical presentation of colitis associated with Clostridium difficile infection in immunosuppressed patients with acquired immunodeficiency syndrome (AIDS) has not been completely characterized. Previous reports suggest that these patients present with low blood leukocyte counts, consistent with the impaired myelopoiesis that can occur with human immunodeficiency virus (HIV) infection. In contrast, we describe the cases of two patients with colitis associated with C difficile infection who developed intense leukemoid reactions despite being in advanced stages of AIDS. To the best of our knowledge, these are the first described cases of leukemoid reaction associated with C difficile or other bacterial infection in AIDS patients. We review the literature on C difficile colitis in patients infected with HIV and suggest that severe C difficile infection should be considered in such patients presenting with leukemoid reaction and diarrhea.

AIDS-Related Opportunistic Infections↗
PubMed1993

[A case of bladder carcinoma representing leukemoid reaction].

A 60-year-old male with locally invasive bladder carcinoma (pT4 pNo Mo) had a remarkable leukocytosis of 64,900/mm3 in the peripheral blood count without any findings of inflammatory disease. The grade 3 transitional cell carcinoma (TCC) measuring 60 by 58 mm involved the prostate, but radiological examinations including abdominal CT scan and isotopic bone scan failed to prove distant metastasis. Serum calcium level was within normal level. Negative bone marrow finding for leukemia strongly suggested a leukemoid reaction by the bladder carcinoma. Preoperative arterial chemoembolization utilizing mitomycin C microcapsules and cisplatin infused into the tumor feeding arteries provided a normalization of leukocyte count (8,200/mm3) in association with a substantial tumor reduction, and was followed by radical cystoprostatectomy. Although the leukocyte count maintained a normal range for 2 months postoperatively, leukocytosis recurred and rapidly progressed to a leukocyte count of 51,300/mm3. CT scan revealed intrapelvic tumor recurrence, and serum analysis for granulocyte colony stimulating factor (G-CSF) demonstrated an elevated value of 130.9 pg/ml (normal, less than 30 pg/ml). The patient is now on systemic chemotherapy. The laboratory data and the response to the treatments would indicate that the leukocytosis in this patient is a leukemoid reaction due to the bladder carcinoma which may release G-CSF. Ten cases of bladder tumor representing leukemoid reaction have been reported in the literature.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Transitory T-lymphoblastic leukemoid reaction in a neonate with Down syndrome.

A transient leukemoid reaction in a neonate with Down syndrome is reported. The blastic proliferation was identified as T lymphoblastic in an early stage of maturation (prethymocytes) using morphological, cytochemical, and immunological methods. A spontaneous complete remission occurred in 8 weeks. No additional cytogenetic alterations were found, except for those concerning chromosome 21. Other cases reported in the literature reveal that cytogenetic studies may be useful to distinguish these transient leukemic reactions from true leukemias in newborns with Down syndrome. The in vitro growth pattern of peripheral blood and bone marrow may also be useful for this purpose.

Blood Cell Count↗
PubMed1992

Myeloblastic leukemoid reaction in paroxysmal nocturnal hemoglobinuria associated with myelodysplasia.

Paroxysmal nocturnal hemoglobinuria (PNH) has been observed to evolve into myelofibrosis and acute myeloid leukemia. Myeloblastic leukemoid reaction has not been described in PNH. We described a patient with PNH with myelodysplasia and septicemia. The marrow aspirates showed a picture of myeloblastosis which subsided when sepsis was controlled. The myeloblastic leukemoid reaction in our patient related to overwhelming sepsis, splenectomy and overt hemolysis.

Bone Marrow↗
PubMedDate not supplied

Agranulocytosis, plasmacytosis, and thrombocytosis followed by a leukemoid reaction due to acute acetaminophen toxicity.

OBJECTIVE: To describe a patient who developed hepatotoxicity, reactive plasmacytosis with thrombocytosis and life-threatening agranulocytosis, followed by a leukemoid reaction, apparently caused by acute acetaminophen toxicity. SETTING: University-affiliated hospital. CASE SUMMARY: A 19-year old white women who took an overdose of acetaminophen developed hepatotoxicity and reactive plasmacytosis with thrombocytosis and life-threatening agranulocytosis, followed by a leukemoid reaction. Symptoms, signs, and laboratory findings regressed with symptomatic therapy during the follow-up period. CONCLUSIONS: We believe that acute acetaminophen toxicity was responsible for these hematologic abnormalities. This profile of hematologic adverse effects associated with acetaminophen toxicity has not been reported previously.

Acetaminophen↗
PubMed2005

Intense paraneoplastic neutrophilic leukemoid reaction related to a G-CSF-secreting lung sarcoma.

A white blood cell count more than 50 x 10(9)/l, not related to bone marrow involvement, is termed leukemoid reaction. We report on the first case of an undifferentiated sarcoma of the lung associated with an intense paraneoplastic neutrophilic leukemoid reaction related to the production of granulocyte colony-stimulating factor (G-CSF). A radiography and a computed tomography scan of the chest revealed a well-limited voluminous and heterogeneous low-density mass of the left lung. The patient died of multiorgan failure related to uncontrolled progressive tumor growth after admission and two cycles of chemotherapy. The patient's G-CSF serum concentration was dramatically elevated (6,538 pg/ml) compared to serum levels observed in normal controls and patients with elevated leukocytosis (31 and 387 pg/ml, respectively). The G-CSF concentration dramatically increased after the first cycle of chemotherapy and during the subsequent neutropenia, as a result of the tumor lyses as well as of disruption of the physiological negative feedback mechanism. Adjunction of the patient's serum to CD34+ cell cultures induced a 12.3-fold increase in CD15+ cells, demonstrating the serum's capacity to induce myeloid differentiation.

Cell Proliferation↗
PubMed1995

Leukemoid reaction resulting from multiple cytokine production in metastatic mucoepidermoid carcinoma with central necrosis.

We report a male patient with metastatic high-grade mucoepidermoid carcinoma and associated leukemoid reaction. The patient was transferred to our hospital due to persistent spiking fever, marked granulocytosis, and suspected liver abscess. After thorough bacteriological studies, including cultures of blood and material aspirated from the "liver abscess", no evidence of infection was documented. The patient suffered from persistent spiking fever for more than 4 weeks in spite of empirical antibiotic treatment, and repeated aspiration of the presupposed liver abscess. He underwent exploratory laparotomy for intended surgical evacuation of the liver abscess and bacteriological diagnosis. The operative findings were compatible with metastatic carcinoma with multiple liver and retroperitoneal lymph node involvement and tumor necrosis. The pathology report indicated high-grade mucoepidermoid carcinoma. Immunohistochemistry showed positive staining for interleukin-1 alpha (IL-1 alpha) and IL-6. Elevation of cytokine levels in the necrotic tumor fluid, including IL-1 alpha, IL-6, granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor was confirmed by ELISA test. This case shows that multiple cytokine production from a metastatic tumor and its central necrotic area in the liver can produce a febrile leukemoid reaction mimicking a pyogenic liver abscess.

Abdominal Neoplasms↗
PubMedDate not supplied

Leukemoid reaction associated with parenteral nutrition.

A hematological picture simulating that seen in cases of leukemia often occurs in a variety of conditions. We recently treated a patient who had a leukemoid reaction in the peripheral blood while he was on parenteral nutrition. Throughout the period of treatment with parenteral nutrition, an abnormal shift towards immaturity in the neutrophilic granulocytes was seen, and the degree of this shift appeared to depend on the caloric intake. Moreover, the hematological picture resembling that seen in cases of leukemia disappeared shortly after discontinuation of the parenteral nutrition, and immature cells were no longer apparent. We assumed that the excess glucose-related calories included in parenteral nutrition produced the leukemoid reaction in this patient who was being surgically treated for carcinoma of the colon with hepatic metastasis.

Aged↗
PubMed1988

Epithelioid sarcoma with diffuse bone marrow metastases and associated leukemoid reaction. A case report and brief literature review.

A patient with a recurrent epithelioid sarcoma of the hand was observed for five years with a diagnosis of nodular fasciitis. Eventually, the patient had a pulmonary metastasis and diffuse bone marrow spread, which was associated with a leukemoid reaction. Bone marrow dissemination by sarcoma is unusual, and its production of a leukemoid reaction very rare; this is its first reported occurrence in epithelioid sarcoma that the authors have been able to identify in the literature.

Adult↗