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Medicine Nov 2015In this study, we describe a patient in whom tigecycline-induced drug fever and leukemoid reaction (LR) after 3 weeks of therapy for pneumonia.A 62-year-old man...
In this study, we describe a patient in whom tigecycline-induced drug fever and leukemoid reaction (LR) after 3 weeks of therapy for pneumonia.A 62-year-old man developed aspiration pneumonia on February 1, 2015. He had received multiple antibiotics at another hospital, but did not respond well. Disease rapidly progressed, and he was referred to our department on February 14. We adjusted the antibiotic therapy to tigecycline + vancomycin, and added voriconazole to empiric antifungal therapy. Pneumonia largely improved, and we discontinued vancomycin and voriconazole on February 28. With tigecycline monotherapy, his clinical status remained stable.On March 7, he developed high fever and LR (white blood cell count: 38.25 × 10(9)/L). Erythrocyte sedimentation rate and C-reactive protein were elevated, and CD8+ T cells had been abnormally activated. After a careful physical examination and laboratory investigation, we confirmed that primary infection did not progress and no other cause was evident. So we figured fever and LR might be induced by tigecycline. After discontinuing tigecycline and adding low-dose steroid, fever and LR totally resolved in 3 days, which further confirmed our diagnosis.According to this case and literature review, drug-induced hypersensitivity should be considered in the differential diagnosis of fever and LR when the therapeutic duration of tetracycline approximates 3 weeks. Monitoring T-cell subsets may facilitate early diagnosis. When necessary, we should discontinue the suspected drug to confirm diagnosis.
Topics: Anti-Bacterial Agents; Fever; Humans; Leukemoid Reaction; Male; Middle Aged; Minocycline; Pneumonia; Tigecycline
PubMed: 26559254
DOI: 10.1097/MD.0000000000001869 -
Cureus Sep 2019Hyperleukocytosis is defined as a white blood cell (WBC) count of ≥ 100,000/µL. Leukostasis refers to symptomatic hyperleukocytosis and is considered a medical...
Hyperleukocytosis is defined as a white blood cell (WBC) count of ≥ 100,000/µL. Leukostasis refers to symptomatic hyperleukocytosis and is considered a medical emergency. In pediatric practice, hyperleukocytosis is most commonly described in leukemia and other myeloproliferative disorder, but other etiologies, such as infection, are less commonly mentioned. In this case report, a one-day-old, preterm, male baby (26 weeks of gestation) was referred for preterm care. A sepsis-induced leukemoid reaction hyperleukocytosis diagnosis was presumed, and he was successfully treated with an empirical antibiotic with a gradual improvement in WBC counts.
PubMed: 31700707
DOI: 10.7759/cureus.5594 -
Science Progress 2021Paraneoplastic syndromes are rarely seen in gynecological tumors especially in endometrial cancer. Early identification of paraneoplastic syndromes plays a significant... (Review)
Review
Paraneoplastic syndromes are rarely seen in gynecological tumors especially in endometrial cancer. Early identification of paraneoplastic syndromes plays a significant role in the treatment and prognosis of cancer. Here, we reported a rare case with endometrial cancer with a 2.7 cm × 2.2 cm × 3.4 cm lesion in the posterior cervix presenting leukemoid reaction and hypercalcemia as paraneoplastic syndromes simultaneously. During the progress of the endometrial cancer, her leukocyte level rose up to 60.7 × 10/L after anti-infection treatment. Meanwhile, the patient represented a series of severe clinical situation including hypercalcemia, hypokalemia, metabolic alkalosis. and respiratory failure. Finally, the patient died of respiratory circulatory failure 2 weeks later. In addition to symptomatic treatment, possible treatment targeted on the primary tumor as early as possible might help to improve the clinical prognosis.
Topics: Endometrial Neoplasms; Female; Humans; Hypercalcemia; Leukemoid Reaction; Leukocytes; Paraneoplastic Syndromes
PubMed: 33844610
DOI: 10.1177/00368504211004028 -
International Journal of General... 2017To report a rare case of extreme leukocytosis and leukemoid reaction associated with lung sarcomatoid carcinoma (LSC) and increase people's awareness of the disease.
PURPOSE
To report a rare case of extreme leukocytosis and leukemoid reaction associated with lung sarcomatoid carcinoma (LSC) and increase people's awareness of the disease.
PATIENTS AND METHODS
A 58-year-old male patient was diagnosed with LSC; however, after the end of the second course of chemotherapy, his white blood cells increased gradually without fever or use of medications such as granulocyte colony-stimulating factor and steroids. A bone marrow biopsy then confirmed it to be a leukemoid reaction.
RESULTS
The patient died of multiple organ failure 2 months after being diagnosed with leukocytosis.
CONCLUSION
LSC associated with leukemoid reaction is very rare and the prognosis is poor. When a patient's white blood cells are extremely elevated, we should think of the possible causes of the tumor itself and identify it with other diseases. However, more data and evidence are still needed to find an effective adjuvant therapy for these patients.
PubMed: 28096688
DOI: 10.2147/IJGM.S102524 -
International Journal of Infectious... Nov 2010Neonatal leukemoid reaction (NLR) is relatively rare and considered as a white blood cell (WBC) count ≥50×10(9)/l . The aim of this study was to investigate the...
OBJECTIVES
Neonatal leukemoid reaction (NLR) is relatively rare and considered as a white blood cell (WBC) count ≥50×10(9)/l . The aim of this study was to investigate the association of NLR with neonatal morbidity and mortality and maternal chorioamnionitis in low birth weight infants.
METHODS
In this case-controlled retrospective study, the medical records of 1200 newborn infants with a birth weight <2500g admitted to the neonatal unit over a period of 5 years were reviewed. The infants who developed features of NLR (n=17, 1.4%) formed the study group, while the remainder without NLR, matched for gestational age and birth weight (n=123), formed the control group. A chart review was performed and salient demographic, clinical, and laboratory data abstracted. A statistical analysis was subsequently performed on this data.
RESULTS
The mean WBC and absolute neutrophil counts of infants with NLR were significantly higher than those in the control group. The peak time of NLR was at 7.9±3.6 (interquartile range (IQR) 1-30) days and on average it improved within 4.1±1.95 (IQR 2-9) days. It was noted that those infants with NLR were mostly born by vaginal delivery and their mothers had a higher rate of early rupture of the membranes and chorioamnionitis. NLR was associated with a 4-fold increase in sepsis, 20-fold increase in intraventricular hemorrhage, 54-fold increase in bronchopulmonary dysplasia, and 6-fold increase in mortality. In the study group, those infants whose mothers had chorioamnionitis had a higher rate of early rupture of the membranes and they developed sepsis and intraventricular hemorrhage more often than those whose mothers did not have clinical chorioamnionitis.
CONCLUSIONS
In low birth weight newborn infants, NLR is significantly associated with sepsis, intraventricular hemorrhage, bronchopulmonary dysplasia, and a high mortality rate. Also, those infants with NLR are more likely to be born to mothers with chorioamnionitis and they face sepsis and intraventricular hemorrhage more often.
Topics: Bronchopulmonary Dysplasia; Case-Control Studies; Chorioamnionitis; Comorbidity; Delivery, Obstetric; Female; Gestational Age; Hemorrhage; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases; Leukemoid Reaction; Leukocyte Count; Male; Neutrophils; Pregnancy; Retrospective Studies; Sepsis
PubMed: 20851018
DOI: 10.1016/j.ijid.2010.06.012 -
BMJ Case Reports Oct 2020A leukemoid reaction is typically defined as white blood cell (WBC) count >50×10/L, predominantly neutrophil precursors, that are not due to tumour involvement in the...
A leukemoid reaction is typically defined as white blood cell (WBC) count >50×10/L, predominantly neutrophil precursors, that are not due to tumour involvement in the bone marrow and not derived from clones. Leukemoid reactions associated with malignancy, known as paraneoplastic leukemoid reactions, are less common and are most notably seen with non-small cell lung cancer. A 64-year-old woman presented with right leg painful ulceration. On examination, she had multiple venous stasis ulcers more severe on the right, with no palpable pulses in her lower extremities. Her WBC count was 124×10/L and platelets were 517×10/L. Arterial dopplers showed limb-threatening arterial insufficiency which prompted right femoral endarterectomy. Few months earlier she was diagnosed with metastatic lung adenocarcinoma to the bone and she had leukemoid reaction with WBC 43.920× 10/L with 90% neutrophils. Repeat imaging showed progression of her malignancy and she passed shortly after. Inflammation is a key element of carcinogenesis and cancer progression. Among the different tumours, lung cancer is a non-haematologic malignancy that is most closely associated with leucocytosis. Some studies have found that leucocytosis was significantly associated with metastasis and shorter survival irrespective of other factors such as age or sex. The mechanism remains unclear however elevated levels of granulocyte colony-stimulating factor (CSF), granulocyte macrophage-CSF and interleukin 6 have been linked to this phenomena. The degree of leucocytosis seen in our patient is suggestive of CSF production leading to a paraneoplastic leukemoid reaction.
Topics: Adenocarcinoma of Lung; Carcinoma, Non-Small-Cell Lung; Endarterectomy; Fatal Outcome; Female; Femoral Artery; Humans; Leg Ulcer; Leukapheresis; Leukemoid Reaction; Lung Neoplasms; Middle Aged; Palliative Care; Paraneoplastic Syndromes; Thrombosis; Ultrasonography, Doppler
PubMed: 33051200
DOI: 10.1136/bcr-2020-235389 -
The Canadian Veterinary Journal = La... May 2022This paper reports a case of neonatal hyperleukocytosis in a dog due to a bacterial infection. A 3-week-old, mixed-breed dog was brought to a veterinary college referral...
This paper reports a case of neonatal hyperleukocytosis in a dog due to a bacterial infection. A 3-week-old, mixed-breed dog was brought to a veterinary college referral center with a history of weight loss despite a good appetite. Clinical and laboratory examinations included: physical examination, complete blood (cell) count (CBC), serum biochemistry profile, abdominal ultrasound examination, and cytology of liver and bone marrow aspirates. The CBC showed hyperleukocytosis of 158.0 × 10/L (RI: 2.1 to 21.2 × 10/L) and hematocrit of 0.19 L/L (RI: 0.21 to 0.34 L/L). The strong leukemoid reaction was comprised of neutrophils, monocytes, and lymphocytes. The dog was diagnosed with liver infection based on liver aspirates and culture. Amoxicillin-clavulanic acid was prescribed. A recheck abdominal ultrasound and CBC repeated 4 wk after initial examination were unremarkable. Neonatal hyperleukocytosis is well-described in human medicine but veterinary studies in small animal neonates are scarce. Key clinical message: Hyperleukocytosis in adult dogs may be caused by leukemia or leukemoid reactions. Generalized sepsis is a leading cause of leukemoid reactions in adult dogs and cats. In puppies, neoplasia is less likely, and other causes should be investigated. Similar to human neonates, puppies can mount a strong leukemoid reaction during an infection, even if it is not a generalized septic process.
Topics: Anemia; Animals; Bacterial Infections; Cat Diseases; Cats; Dog Diseases; Dogs; Humans; Leukemoid Reaction
PubMed: 35502256
DOI: No ID Found -
Cureus Feb 2021Leukemoid reaction is a rare clinical condition defined by marked leukocytosis with predominantly mature neutrophils. It is an uncommon condition with...
Leukemoid reaction is a rare clinical condition defined by marked leukocytosis with predominantly mature neutrophils. It is an uncommon condition with reported incidence of less than 1% in hospitalized patients. The major causes of leukemoid reaction are severe infection (clostridium difficile colitis, tuberculosis, or severe shigellosis), malignancies, intoxication, and severe hemorrhage. This article presents a case report of a 64-year-old female with severe COVID-19 infection who presented with marked leukocytosis. After extensive workup to exclude hematologic malignancy, the patient was diagnosed to have a leukemoid reaction.
PubMed: 33815998
DOI: 10.7759/cureus.13598 -
The Journal of Thoracic and... Apr 2018
Topics: Aged; Aortic Valve; Aortic Valve Stenosis; Diagnosis, Differential; Female; Heart Valve Prosthesis Implantation; Humans; Leukemoid Reaction; Leukocytes; Predictive Value of Tests; Treatment Outcome
PubMed: 29366572
DOI: 10.1016/j.jtcvs.2017.08.125 -
Archives of Pathology & Laboratory... Mar 2020Transient abnormal myelopoiesis is a hematopoietic disorder that occurs in up to 10% of neonates with Down syndrome. It is characterized by leukocytosis and the presence... (Review)
Review
Transient abnormal myelopoiesis is a hematopoietic disorder that occurs in up to 10% of neonates with Down syndrome. It is characterized by leukocytosis and the presence of circulating blast cells harboring truncating mutations with variable multiorgan system involvement. Placental involvement of transient abnormal myelopoiesis is infrequently described. Placental examination and identifying features related to transient abnormal myelopoiesis could be one of the early, if not the only, means of diagnosis of this condition in affected stillbirths, premature infants, and a subset of asymptomatic neonates. This article provides an overview of the placental pathology in transient abnormal myelopoiesis with review of the literature, and also discusses the important differential diagnoses.
Topics: Down Syndrome; Female; GATA1 Transcription Factor; Humans; Infant, Newborn; Leukemoid Reaction; Mutation; Placenta; Pregnancy
PubMed: 30969155
DOI: 10.5858/arpa.2018-0248-RS