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leukemoid reaction
Etiology:
1) infectious disease caused by bacteria or viruses
a) tuberculosis
b) diptheria
c) chickenpox
d) Clostridium difficile most common nosocomial cause [3]
2) eclampsia
3) burns
4) toxic agents
5) malignant neoplasms
a) carcinoma of the colon
b) carcinoma of the lung
c) carcinoma of the kidney
6) acute hemorrhage or hemolysis
7) glucocorticoids
8) G-CSF therapy
9) cardiac arrest
10) hepatorenal syndrome
Pathology:
- a moderate, advanced or sometimes extreme degree of leukocytosis in blood, similar to that occurring in various forms of leukemia, but not the result of leukemic disease
- generally, there is a disproportionate increase in one of the forms of leukocytes (including immature stages)
- examples of myelocytic, lymphocytic, monocytic or plasmocytic leukemoid reactions may be indistinguishable from leukemias
Laboratory:
- complete blood count
- leukocytosis, WBC count < 45,000/uL; > 50,000/uL (MKSAP19) [3]
Differential diagnosis:
- leukemia, especially chronic myeloid leukemia
- if WBC count is > 45,000/mm3, the most likely cause is leukemia
- if WBC < 45,000/mm3, infection is the most likely etiology
General
leukocytosis
myeloproliferative disorder
References
- Stedman's Medical Dictionary 26th ed, Williams &
Wilkins, Baltimore, 1995
- Reding et al AM J Med 104:12-16 1998
- Medical Knowledge Self Assessment Program (MKSAP) 17, 19
American College of Physicians, Philadelphia 2015, 2022