Leukemoid Reaction: Difference between revisions

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* Compared to age-matched controls with moderate leukocytosis (12-24k)
* Compared to age-matched controls with moderate leukocytosis (12-24k)
* Patients with leukemoid reaction were more likely to have an infection, be hospitalized and die.
* Patients with leukemoid reaction were more likely to have an infection, be hospitalized and die.
==Clinical Features==


==Differential Diagnosis==
==Differential Diagnosis==
[[File:Leukemoid Reaction.png|Differential Diagnosis of Leukemoid Reaction]]
[[File:Leukemoid Reaction.png|Differential Diagnosis of Leukemoid Reaction]]
==Management==
==Disposition==


==External Links==
==External Links==
* [https://ddxof.com/leukemoid-reaction/ Leukemoid Reaction on ddxof]
*[https://ddxof.com/leukemoid-reaction/ Leukemoid Reaction on ddxof]


==References==
==References==
<references/>
<references/>
[[Category:Heme/Onc]]

Revision as of 01:21, 16 September 2018

Background

  • Markedly elevated leukocyte (particularly neutrophil) count without hematologic malignancy
  • Cutoff is variable, 25-50k[1]

Literature Review

Retrospective review of 135 patients with WBC >25k [2]

  • 48% infection
  • 15% malignancy
  • 9% hemorrhage
  • 12% glucocorticoid or granulocyte colony stimulating therapy

Retrospective review of 173 patients with WBC >30k [3]

  • 48% infection (7% C. difficile)
  • 28% tissue ischemia
  • 7% obstetric process (vaginal or cesarean delivery)
  • 5% malignancy

Observational study of 54 patients with WBC >25k [4]

  • Consecutive patients presenting to the emergency department
  • Compared to age-matched controls with moderate leukocytosis (12-24k)
  • Patients with leukemoid reaction were more likely to have an infection, be hospitalized and die.

Clinical Features

Differential Diagnosis

Differential Diagnosis of Leukemoid Reaction

Management

Disposition

External Links

References

  1. Sakka V, Tsiodras S, Giamarellos-Bourboulis EJ, Giamarellou H. An update on the etiology and diagnostic evaluation of a leukemoid reaction. Eur J Intern Med. 2006;17(6):394-398. doi:10.1016/j.ejim.2006.04.004.
  2. Reding MT, Hibbs JR, Morrison VA, Swaim WR, Filice GA. Diagnosis and outcome of 100 consecutive patients with extreme granulocytic leukocytosis. Am J Med. 1998;104(1):12-16.
  3. Potasman I, Grupper M. Leukemoid reaction: spectrum and prognosis of 173 adult patients. Clin Infect Dis. 2013;57(11):e177-e181. doi:10.1093/cid/cit562.
  4. Lawrence YR, Raveh D, Rudensky B, Munter G. Extreme leukocytosis in the emergency department. QJM. 2007;100(4):217-223. doi:10.1093/qjmed/hcm006.