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Leukocytosis induced by plasma exchange.

A significant increase was found in the number of white blood cells, including neutrophils, in the peripheral blood of patients during plasma exchange. However, the spontaneous chemiluminescence of peripheral white blood cells (basically characterized the activated state of neutrophils) was not elevated. This finding suggests a relative deficiency in the metabolism of neutrophils during plasma exchange. This idea is supported by the observation that the levels of malonyldialdehyde in plasmas, after plasma exchange, do not increase, indicating that the activation dependent lipid peroxidation in neutrophils did not take place.

Humans↗

[The prognostic significance of high leukocytosis in acute myocardial infarct].

39 patients with an acute myocardial infarction and high leucocytosis of greater than or equal to 15.0,10(9)/l, were studied in order to find out the relation of the high leucocytosis and the final prognosis of the disease. The high leucocytosis of greater than or equal to 15.0.10(9)/l was found for several up to 10-12 h after the onset of the painful attack in patients with a large, combined and obligatory transmural acute myocardial infarction. Leucocytosis of greater than or equal to 19.5.10(9)/l was found in all patients who died. The high leucocytosis is due to the mobilization of the bone marrow neutrophil reserve. The high leucocytosis of greater than or equal to 15.0.10(9)/l is an important prognostic sign for the final outcome of acute myocardial infarction.

Aged↗

Extreme leukemic leukocytosis (blast crisis) in childhood.

Children with leukemia who have extremely high leukocyte counts (more than 100,000/mm3) when seen initially are at high risk of early sudden death, usually from massive intracerebral hemorrhage. Nine such patients were seen during a 39-month period. Eight had pronounced adenopathy and hepatosplenomegaly without severe anemia or thrombocytopenia. The first six patients died suddenly. Cerebral perivascular infiltration and increased blood viscosity are the probable pathophysiologic mechanisms. A treatment program was developed, the goal being the early elimination of blast cells. Three consecutive patients patients presenting with leukocyte counts greater than 100,000/mm3 were treated with emergency cranial irradiation, and all three survived to receive systemic chemotherapy.

Acute Disease↗

Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis.

Twenty-four cases of anaplastic thyroid carcinoma seen in the National Taiwan University Hospital from 1980 to 1988 were reviewed. The median age was 61.5 years. The ratio of men to women was 1:1.4. A preceding history of long-standing goiter could be obtained in 14 patients (58.3%) with a median duration of 20 years. Twenty patients (83.3%) presented with a rapid-growing neck mass with a median duration of 1.3 months. Nine out of 19 patients (47.4%) had white blood cell (WBC) counts over 10,000/microliters, which were closely related to the presence of fever (p less than 0.02). Serial follow-up showed that WBC and platelets gradually increased but red blood cells and hemoglobin decreased. Fever was noted at the time of diagnosis in 8 out of 24 patients (33.3%), and was closely related to the presence of abundant neutrophils in the cytologic smears of thyroid aspirates (p less than 0.01). Fever was not due to bacterial infection. Three out of 10 patients (30.0%) had calcification in the thyroid shown on neck X ray, and 7 out of 18 patients (38.9%) had lung metastasis shown on chest X ray. The ultrasonographic images of thyroid anaplastic carcinoma done in 6 patients were heterogeneous and hypoechoic. Fine-needle aspiration cytology was done in 20 patients. Anaplastic thyroid carcinoma was easily diagnosed in 18 patients (90.0%). One was misdiagnosed as acute thyroiditis. Another one was diagnosed as papillary carcinoma cytologically, which combined with anaplastic carcinoma shown on histology. The median survival was 2.2 months, ranging from 0.2 to 25.3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Bacteriuria, leukocytosis, and fever after transurethral prostatectomy.

Transurethral prostatectomy was performed in 71 patients, whose body temperature and leukocyte count were recorded for four days. Twenty-four of the patients had a pre- or postoperative urinary tract infection. The fever index scores (temperature X hours) of both the infected and noninfected patients increased similarly on the day of surgery and postoperative day 1; the scores of the noninfected then decreased rapidly, while those of the infected declined gradually. There was a similar pattern in leukocyte counts. It is hypothesized that the fever associated with transurethral prostatectomy in noninfected patients is a swift reaction to bacteremia, which is promptly overcome; infected patients, who do not react as quickly, experience prolonged infection and fever.

Bacteriuria↗