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Journal of Clinical and Diagnostic... May 2016Chikungunya is a viral illness caused by an arbovirus which is transmitted by Aedes mosquito. Fever and polyarthralgia are hallmark of this viral illness. Viral...
Chikungunya is a viral illness caused by an arbovirus which is transmitted by Aedes mosquito. Fever and polyarthralgia are hallmark of this viral illness. Viral infections are generally associated with leucopenia and bacterial infections with leukocytosis. Leukemoid Reaction (LR) is defined by reactive increase in leukocyte count of more than 50,000/cu mm with increase in mature leukocytes on peripheral blood. Leukocytosis is common in Chikungunya but leukemoid reaction has not been reported in medical literature. Our patient presented with high grade fever and symmetrical polyarthritis. Blood investigation showed Leukemoid reaction and after extensive work up a diagnosis of chikungunya was made.
PubMed: 27437276
DOI: 10.7860/JCDR/2016/18434.7720 -
European Review For Medical and... Dec 2012To the Authors' knowledge, the literature regarding leukemoid reaction in patients with malignant bone tumor is sparse, and most of patients with leukemoid reaction have...
BACKGROUND
To the Authors' knowledge, the literature regarding leukemoid reaction in patients with malignant bone tumor is sparse, and most of patients with leukemoid reaction have poor prognosis.
AIM
To study the leukemoid reaction in malignant bone tumor patients.
MATERIALS AND METHODS
A total of 105 consecutive malignant bone tumor patients with a white blood cell count > 50,000/microL were retrospectively identified over a 4-years period (2007-2010). Those patients without a secondary cause of their leukocytosis were defined as having a paraneoplastic leukemoid reaction.
RESULTS
Three etiologies of the leukocytosis were found in those 105 patients: the major one was paraneoplastic leukemoid reaction which accounted for 56%; the second one was hematopoietic growth factors defect accounting for 30%; 14% patients were caused by infection and Tumor bone marrow involvement. The patients diagnosed with a paraneoplastic leukemoid reaction typically had neutrophil predominance (94.8%) and radiographic evidence of metastatic diseases (78%). They were clinically stable, but had a poor prognosis. 95% either died or were discharged to hospice within 12 weeks of their initial extreme leukocyte count. Both of the 2 (2%) patients who survived over 12 weeks received effective antineoplastic therapy.
CONCLUSIONS
Patients with typical paraneoplastic leukemoid reaction were clinically stable despite having large tumor burdens. However, clinical outcomes were poor unless receiving an effective antineoplastic treatment.
Topics: Adult; Aged; Bone Neoplasms; China; Communicable Diseases; Cytokines; Female; Hematopoietic Cell Growth Factors; Humans; Leukemoid Reaction; Leukocytes; Male; Middle Aged; Paraneoplastic Syndromes; Prognosis; Retrospective Studies; Risk Factors; Time Factors; Tomography, X-Ray Computed
PubMed: 23242713
DOI: No ID Found -
The Journal of Maternal-fetal &... Dec 2023Neonatal leukemoid reaction is associated with higher risk of mortality, chronic lung disease and has been associated with chorioamnionitis. Literature on extremely low...
BACKGROUND
Neonatal leukemoid reaction is associated with higher risk of mortality, chronic lung disease and has been associated with chorioamnionitis. Literature on extremely low birth weight infants with leukemoid reaction is limited.
OBJECTIVES
The aim of our study was to characterize the maternal and placental factors associated with neonatal leukemoid reaction and to describe outcomes of these ELBW infants. Our objective was to assess if there were maternal factors that would assist the decision-making process regarding the delivery of preterm infants at risk of chorioamnionitis and the sequelae of this inflammatory process.
METHODS
This was a retrospective case-control study performed in a single, tertiary Maternity Hospital in Dublin. Two matched controls were identified for each case based on gestation and year of birth and data was collected on both the infants and their mothers.
RESULTS
7 extremely preterm neonates were identified as having a leukemoid reaction, defined as a total white cell count of >50,000 or in the first seven days of life. Baseline characteristics between the groups were similar. The median gestational age in the cases group was 24 + 4 weeks and in the control group was 24 + 1. The mean birthweight was 650 g in the cases group vs. 655 g in the control group. There was a higher percentage of males in the control group, 42.9% vs 28.6% in the cases. The preterm infants with leukemoid reaction had a longer duration of ventilation with a median of 18 days (7.5-23.5 days) compared to 6.5 days (2.8-24.5 days) in the control group. More infants in the leukemoid reaction group required inotropes for hypotension in the first 72 h after delivery (42.9% vs 7.1% in the controls, value .169). Death or Bronchopulmonary dysplasia (BPD) occurred in 85.7% of the cases identified with a leukemoid reaction vs 71.4% of the controls matched. Median maternal CRP was higher in cases prior to delivery vs the controls (66 vs 18.1 mg/L, -value = .2151). There was histological evidence of maternal inflammatory response in all cases with fetal inflammatory response in 71% of cases.
CONCLUSIONS
Leukemoid reaction in ELBW infants with evidence of maternal and fetal inflammatory response syndrome on placental histology is associated with a longer duration of initial ventilation, increased need for inotropes in the first 72 h after birth, higher rates of death, and BPD. Prospective studies are required to identify potential biomarkers such as proinflammatory cytokines, IL-6, which might aid the decision-making process in delivery.
Topics: Infant; Male; Infant, Newborn; Humans; Female; Pregnancy; Infant, Extremely Premature; Retrospective Studies; Leukemoid Reaction; Case-Control Studies; Chorioamnionitis; Intensive Care Units, Neonatal; Placenta; Gestational Age; Bronchopulmonary Dysplasia
PubMed: 37322830
DOI: 10.1080/14767058.2023.2225115 -
SpringerPlus 2015Adult-onset Still's disease is a rare systemic inflammatory disorder of unknown aetiology characterized by the classic triad of persistent high spiking fevers, joint...
INTRODUCTION
Adult-onset Still's disease is a rare systemic inflammatory disorder of unknown aetiology characterized by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon-colored bumpy rash however, the multiorgan involvement can be present.
CASE DESCRIPTION
A 40-year-old woman previously healthy was referred to our hospital with 7 days of high fever and generalized arthralgia, The physical exam revealed angioneurotic edema detected on soles, palms and tongue and widespread red, urticated plaques in a symmetrical distribution affecting the arms, dorsal hands, upper and lower chest and back. Followed 5 days later by fever, the patient presented dyspnea, cough and hypoxemia, the imaging studies showed unilateral consolidation and pleural effusion. The bronchoscopy with bronchoalveolar lavage and skin biopsy were consistent with neutrophilic urticarial. The hematological disorders, infections and other autoimmune diseases were excluded.
DISCUSSION AND EVALUATION
The diagnosis of adult-onset Still's disease can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of Adult-onset Still's disease have been reported but these are not so well known.
CONCLUSIONS
The evidence of rare manifestations is growing and the early clinical presentation of Adult-onset Still's is extremely variable, making diagnosis difficult. For this reason, data on early clinical presentation of the disease are of interest. We reported the first case of acute Adult-onset Still's disease with the association of pulmonary hemorrhage, urticaria and angioedema including a rare systemic manifestation as leukemoid reaction.
PubMed: 25977887
DOI: 10.1186/s40064-015-0924-8 -
In Vivo (Athens, Greece) 2022Concomitant immunity (CIM) is a phenomenon that elicits an antitumor response not sufficient enough to destroy the primary tumor but prevents a secondary implant from...
BACKGROUND/AIM
Concomitant immunity (CIM) is a phenomenon that elicits an antitumor response not sufficient enough to destroy the primary tumor but prevents a secondary implant from growing and spreading. This study aimed to develop a method of identification of serum tumoricidal factors released into circulation during CIM and to compare the CIM-related effect to the effect elicited by the cytotoxic drug doxorubicin.
MATERIALS AND METHODS
SL2 tumor-bearing mice were studied at three time points - day 4, day 7, and day 11 following i.p. 5×10 cell implantation. Hematological effects and thymocyte immunophenotyping (CD4/CD8) data were compared to the effects induced by intravenous 10 mg/kg doxorubicin (DOX) administration to intact DBA 2 mice. The level of plasma colony stimulating factor-granulocyte macrophage (CSF-GM) was evaluated by ELISA.
RESULTS
Identical thymus histopathology and an extent of double-positive CD4+CD8+ subset depletion was found in day 11 tumor-bearing mice (TBM-11) and in DOX-administered animals. TBM-11 exhibited a leukemoid reaction with an increase in monocyte and granulocyte counts. Conversely, DOX administration was followed by severe leukocytopenia at the 72-h time point. No increase in CSF-GM was observed in mice with or without a leukemoid reaction.
CONCLUSION
The complexity of CIM can be examined by tracking alterations in the most fragile cortical CD8+CD4+ double positive population. Thymocyte apoptosis induced by DOX and TBM-11 might be associated with different mechanisms. TBM-11 did not exhibit severe myelotoxicity as DOX did. CIM-related serum factors can be assessed and screened via thymocyte subset analysis.
Topics: Animals; Antineoplastic Agents; Doxorubicin; Granulocyte-Macrophage Colony-Stimulating Factor; Leukemoid Reaction; Mice; Mice, Inbred DBA
PubMed: 35478153
DOI: 10.21873/invivo.12808 -
Oxford Medical Case Reports Sep 2022Scrub typhus is a mite borne zoonosis, caused by , a gram-negative intracellular organism. This infection usually presents in high prevalence in the rural areas of East...
Scrub typhus is a mite borne zoonosis, caused by , a gram-negative intracellular organism. This infection usually presents in high prevalence in the rural areas of East Asia and Western pacific islands. It usually presents with fever, chill, myalgia, headache, skin rashes, having pathognomonic and skin lesion i.e. eschar in ~10% cases in Indian subcontinent. It can present with life-threatening complications on occasional. The simultaneous presentation of more than two complications is uncommon, rarely reported in literature. Here we report a case of 37-year-old woman with acute febrile illness, complicated with myocarditis, acute liver failure and leukemoid reaction. She was diagnosed promptly and successfully treated with doxycycline with full recovery of the complications.
PubMed: 36176945
DOI: 10.1093/omcr/omac092 -
Cancer Medicine Jun 2016EphA4 belongs to the largest family of receptor tyrosine kinases (RTKs). Although EphA4 is highly expressed in the central nervous system, EphA4 has also been...
UNLABELLED
EphA4 belongs to the largest family of receptor tyrosine kinases (RTKs). Although EphA4 is highly expressed in the central nervous system, EphA4 has also been implicated in cancer progression. Most of the studies focus on the expression and function in tumor cells. It is unknown whether EphA4-deleted microenvironment affects tumor progression. Some of cancers in animals and humans, such as 4T1 cancer cells, are known to produce a large amount of granulocyte colony-stimulating factors (G-CSF/Csf3) which can stimulate myeloproliferation, such as myeloid-derived suppressor cells (MDSCs) leading to a poor recipient prognosis. We isografted 4T1 breast cancer cells into both EphA4-knockout and control wild-type female littermate mice. The results showed that the EphA4-deleted host could inhibit primary tumor growth and tumor metastasis mainly by decreasing the amount of IGF1 synthesis in the circulation and locally tissues. The EphA4-deleted microenvironment and delayed tumor development reduced the production of G-CSF resulting in the decrease of splenomegaly and leukemoid reaction including MDSCs, which in turn inhibit the tumor progression. This inhibition can be reversed by supplying the mice with IGF1. However, an excess of IGF1 supply over demand to the control mice could not further accelerate the tumor growth and metastasis. A better understanding and re-evaluation of the main role of IGF1 in regulating tumor progression could further enhance our cognition of the tumor development niche. Our findings demonstrated that EphA4-deleted microenvironment impairs tumor-supporting conditions.
CONCLUSION
Host EphA4 expression regulates cancer development mainly via EphA4-mediated IGF1 synthesis signal. Thus, targeting this signaling pathway may provide a potential therapeutic option for cancer treatment.
Topics: Animals; Biomarkers; Breast Neoplasms; Cell Line, Tumor; Cell Proliferation; Disease Models, Animal; Female; Gene Deletion; Gene Expression; Genes, Reporter; Granulocyte Colony-Stimulating Factor; Hematopoiesis, Extramedullary; Insulin-Like Growth Factor I; Leukemoid Reaction; Mice; Mice, Knockout; Neoplasm Metastasis; Receptor, EphA4; Signal Transduction; Splenomegaly; Tumor Burden; Tumor Microenvironment
PubMed: 26923183
DOI: 10.1002/cam4.670 -
Indian Pediatrics Nov 2015
Topics: Child; Child, Preschool; Female; History, 20th Century; History, 21st Century; Humans; Infant; Infant, Newborn; Leukemoid Reaction; Male
PubMed: 26615346
DOI: 10.1007/s13312-015-0755-2 -
Clinical Pathology (Thousand Oaks,... 2021Leukemoid reaction (LR), which is defined as leukocytosis with a white blood cell (WBC) count above 50 000/µL, can be caused by various conditions, while...
Leukemoid reaction (LR), which is defined as leukocytosis with a white blood cell (WBC) count above 50 000/µL, can be caused by various conditions, while paraneoplastic leukemoid reaction (PLR), a rare type of paraneoplastic syndrome, occurs in cases of solid tumors. Here we report 2 cases of high-grade urothelial carcinoma (HGUC) with PLR accompanied by rapid tumor progression after complete resection of the primary tumor. We reviewed the patient's clinical history, histopathology, and the results of laboratory tests to rule out LR induced by non-tumor causes. In both cases, PLR appeared after primary tumor resection, and the patients died of disease at the peak of PLR at 6 and 8 weeks. Immunohistochemistry for granulocyte colony-stimulating factor and its receptor was performed on tumor tissues. Patients with HGUC and PLR are rare and have an extremely poor prognosis. The mechanism by which solid tumors are associated with PLR and rapid tumor progression after surgical resection of the primary tumor is incompletely understood and will be discussed here.
PubMed: 34291205
DOI: 10.1177/2632010X211030515 -
Innere Medizin (Heidelberg, Germany) Dec 2022Paraneoplastic leukocytosis in solid tumors is associated with poor prognosis. While mild leukocytosis is common, paraneoplastic hyperleukocytosis is extremely rare. The...
Paraneoplastic leukocytosis in solid tumors is associated with poor prognosis. While mild leukocytosis is common, paraneoplastic hyperleukocytosis is extremely rare. The case of a 73-year-old male diagnosed with an adenocarcinoma of the lung and a peak white blood cell count of 178,000/µl is reported. The patient succumbed to the disease after two cycles of immunochemotherapy only 2 months after first hospital admission. Specific treatment options are still under investigation and have not been reported in clinical use.
Topics: Male; Humans; Aged; Leukocytosis; Lung Neoplasms; Leukocyte Count; Lung
PubMed: 36149442
DOI: 10.1007/s00108-022-01407-8