Estimations of a degree of steroid induced leukocytosis in patients with acute infections

Abstract

Background: Glucocorticosteroids (GCS) are known to cause the hematologic effect of leukocytosis and neutrophilia. Leukocytosis is a key parameter in establishing the diagnosis of sepsis and in the estimation of its severity.

Objective: To quantify the effect of chronic or acute GCS treatment on the level of leukocytosis in patients with acute infectious process.

Methods: We conducted a retrospective cohort study of patients with an acute infection hospitalized in tertiary medical center between the years 2003-2014. Patients were classified into three categories: chronic GCS treatment, acute GCS treatment, no GCS treatment. The primary outcome was the maximal WBC count within the first 24h from admission.

Results: We identified 5468 patients with acute infection: 333 of them with chronic GCS treatment, 213 with acute GCS treatment and 4922 with no GCS treatment. The overall maximal leukocytes count was higher in GCS therapy groups: 15.4±8.3×10⁹/L for the acute GCS treatment, 14.9±7.4×10⁹/L for chronic GCS treatment and 12.9±6.4×10⁹/L for the no GCS group (P<0.001).

Conclusion: In patients with acute infections chronically treated with GCS, an increase in the WBC is at average of 5×10⁹/L. These data must be taken into consideration while using the level of leukocytosis as a parameter in the diagnosis of the infectious process.