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Case Reports
. 2013 Apr 19:2013:bcr2012008385.
doi: 10.1136/bcr-2012-008385.

Extreme hyperleucocytosis of the premature

Esther Jansen  1 , Judith Emmen, Thilo Mohns, Albertine Donker
Affiliations
Case Reports

Extreme hyperleucocytosis of the premature

Esther Jansen et al. BMJ Case Rep. .

Abstract

Physiological leucocytosis is common in neonates. Leukemoid reaction is defined as a variable degree of leucocytosis with immature precursors, similar to that occurring in leukaemia but because of other causes. Leukemoid reactions are well-recognised in the neonatal intensive care unit population and are associated with antenatal corticosteroids, Down's syndrome, chorioamnionitis, funisitis and perinatal infections. However, extreme hyperleucocytosis, exceeding a white blood cell count of 100×10(9)/l is rare. In the 7-year period from 2005 to 2012 three premature infants in our hospital presented with extreme hyperleucocytosis. Since there were no signs of neonatal leukaemia, transient myeloid disorder or leucocyte adhesion defect, a leukemoid reaction owing to antenatal corticosteroids, chorioamnionitis and funisitis was diagnosed. No obvious complications of hyperleucocytosis were observed. Therapy was not necessary and the leucocytes normalised spontaneously. In our small case series, extreme hyperleucocytosis in prematures occurred in the absence of leukaemia and had a mild course.

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Figures

Figure 1
Figure 1
Toxic granulation of patient 1.
Figure 2
Figure 2
Course of leucocytes.
Figure 3
Figure 3
Decision tree in case of hyperleucocytosis.
See this image and copyright information in PMC

References

    1. Holland P, Mauer AM. Myeloid leukemoid reactions in children. Arch Pediatr Adolesc Med 1963;2013:568–75 - PubMed
    1. Calhoun DA, Kirk JF, Christensen RD. Incidence, significance, and kinetic mechanism responsible for leukemoid reactions in patients in the neonatal intensive care unit: a prospective evaluation. J Pediatr 1996;2013:403–9 - PubMed
    1. Rastogi S, Rastogi D, Sundaram R, et al. Leukemoid reaction in extremely low-birth-weight infants. Am J Perinatol 1999;2013:93–7 - PubMed
    1. Duran R, Ozbek UV, Ciftdemir NA, et al. The relationship between leukemoid reaction and perinatal morbidity, mortality, and chorioamnionitis in low birth weight infants. Int J Infect Dis 2010;2013:e998–1001 - PubMed
    1. Cohen A, Barak M, Herschkowitz S, et al. Leukemoid reaction induced by prenatal administration of betamethasone. Acta Paediatr Jpn 1993;2013:534–6 - PubMed

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