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Leukemoid reaction and preterm

Toshihiko Nakamura, Daisuke Hatanaka, Michiko Kusakari, Kohei Kashima, Yuji Takizawa, Hidehiro Takahashi, Toshiro Yoshioka, Naoto Takahashi, Takashi Kamohara
Leukemoid reaction (LR) is a reactive disease that exhibits abnormal blood values similar to leukemia, but not due to leukemia. One report showed that neonatal LR (NLR) was associated with elevated serum granulocyte colony stimulating factor (G-CSF) in only 30% of the study neonates. NLR is not always associated with the elevation of serum G-CSF. NLR was defined as a white blood cell count of ≥ 40 × 103 /μL and/or blast cell concentration of > 2%. We have focused on NLR with fetal inflammatory response syndrome (FIRS), defined as a fetal systemic inflammatory reaction triggered by intrauterine infection...
February 2018: Tohoku Journal of Experimental Medicine
Ashok Kumar, Preetam Kumar, Sriparna Basu
Enterococcus fecalis is a nosocomial, opportunistic pathogen, known to cause late-onset sepsis in preterm neonates and is notorious for its association with high mortality and resistance to commonly used antibiotics, such as penicillin, ampicillin, aminoglycosides, and vancomycin. Neonatal leukemoid reaction, defined as the white blood cell count ≥50×10/L or absolute neutrophil count >30×10/L, is a poor prognostic factor in chorioamnionitis. Occurrence of neonatal leukemoid reaction in E. fecalis-mediated sepsis is rare...
October 2015: Journal of Pediatric Hematology/oncology
Sota Iwatani, Masami Mizobuchi, Toshiki Sofue, Satoshi Tanaka, Hitomi Sakai, Seiji Yoshimoto, Hideto Nakao
Chorioamnionitis due to Candida species is relatively rare, despite the high prevalence (20-25%) of Candida vulvovaginitis during pregnancy. We describe a case of neonatal leukemoid reaction (NLR) associated with Candida albicans chorioamnionitis. A male infant was born at 31 weeks' gestation and weighed 1864 g. Laboratory tests at birth indicated marked leukocytosis (i.e. total leukocyte count 89.8 × 10(9) /L including 66% polymorphonuclear leukocytes and 15% band forms). Samples of the infant's pharyngeal mucus and tracheal aspirate were positive for Candida albicans...
April 2014: Pediatrics International: Official Journal of the Japan Pediatric Society
Dilek U Isik, Ozge Aydemir, Yusuf Kale, Husniye Yucel, Ahmet Y Bas, Nihal Demirel, Nilufer Arda, Sema Apaydin
Leukemoid reaction, defined as a total leukocyte count of >50,000/mm, is most commonly related to antenatal administration of steroids, infections, and transient myeloproliferative disorder of Down syndrome in newborns. Atypical presentations of viral infections can be a diagnostic challenge in the newborn period. Cytomegalovirus (CMV) infection causes a multisystem disease, and symptomatic infants generally present with intrauterine growth restriction, hepatosplenomegaly, cholestasis, rash, thrombocytopenia, and microcephaly...
July 2014: Journal of Pediatric Hematology/oncology
Sushanth, K Shreedhara Avabratha, Kiran Joseph Tauro, G K Shwethadri
A preterm baby presented with lethargy and tachypnea. Blood counts revealed hyperleukocytosis. Peripheral smear and bone marrow examination were not suggestive of leukemia. The baby was treated for sepsis. The baby recovered and WBC counts gradually reduced. Hyperleukocytosis was presumed to be a part of leukemoid reaction secondary to sepsis. The diagnostic possibilities with a review of literature are also presented.
July 2010: Indian Journal of Medical and Paediatric Oncology
J Wirbelauer, W Thomas, C Siauw, R Wössner, C P Speer
Extremely immature preterm infants rarely present with a leukocytosis exceeding 30,000/microL. The pathogenetic sequence leading to leukemoid reactions in non-malignant diseases remains to be elucidated. Potential triggers for leukemoid reactions in premature infants include prenatal corticosteroids, chorioamnionitis and funisitis or systemic infection. In the two-year period from 2006 to 2007 all infants with a gestational age of less than 26 weeks were screened for leukocytosis. Among our cases, one preterm infant presented with a leukocyte count of 229,300/microL at the age of 48 hours, lasting throughout the first three weeks of life...
October 2008: Zeitschrift Für Geburtshilfe und Neonatologie
Vincenzo Zanardo, Stefania Vedovato, Daniele D Trevisanuto, Agnese Suppiej, Erich Cosmi, Gian Franco Fais, Silvia Chiarelli
We investigated whether histological chorioamnionitis (HCA) is a risk factor predisposing to leukemoid reaction (LR) and whether LR is associated with the preterm parturition syndrome and the systemic fetal inflammation response syndrome. A prospective histological study on placentas was performed in preterm infants (<or=32(+6) weeks' gestation) admitted to level III neonatal intensive care unit of Padua University from January 1998 to December 2003. Development of LR was related to evidence of HCA. Among the placentas of the 223 preterm examined infants, 61 (27%) were diagnosed with HCA...
January 2006: Human Pathology
Vincenzo Zanardo, Valentina Savio, Carlo Giacomin, Andrea Rinaldi, Francesco Marzari, Silvia Chiarelli
Leukemoid reaction in low-birth-weight (LBW) infants is a rare, recently documented phenomenon, implicated in the sequence of multiorgan inflammatory diseases of preterm infants. The aim of the present paper is to establish whether a neonatal leukemoid reaction is related to bronchopulmonary dysplasia (BPD) development in LBW infants. The design was a case-controlled, retrospective study of all premature infants (born </=31 weeks' gestation) admitted to the neonatal intensive care unit (NICU) over a period of 3 years, from January 1998 to December 2000...
October 2002: American Journal of Perinatology
S Rastogi, D Rastogi, R Sundaram, J Kulpa, A J Parekh
The objective of this paper was to determine the incidence of leukemoid reaction and to evaluate its relationship with maternal and neonatal factors in extremely low-birth-weight (ELBW) infants. The design a case-controlled retrospective study of all live-born ELBW infants (<1000 g) over a period of 2 years, from July 1994 to June 1996. A total of 60 preterm infants were born during the study period, and are included in this report. The infants who demonstrated leukemoid reaction formed the study group, while the remainder formed the control group...
1999: American Journal of Perinatology
D A Calhoun, J F Kirk, R D Christensen
OBJECTIVE: To prospectively investigate the incidence, significance, and kinetic mechanism responsible for leukemoid reactions in patients in the neonatal intensive care unit (NICU). DESIGN: We prospectively studied all infants admitted to the NICU at the University of Florida who, during a period of 12 consecutive months, had a leukemoid reaction. All those identified had a standardized evaluation consisting of (1) karyotype analysis, (2) bacterial cultures, (3) evaluations for toxoplasmosis, other (congenital syphilis and viruses), rubella, cytomegalovirus, and herpes simplex virus) (TORCH), (4) determination of blood viscosity, (5) use of marrow aspirates for morphology, clonogenic progenitor cell assays, and cell-cycle analysis of progenitors, (6) determination of serum concentrations of granulocyte and granulocyte-macrophage colony-stimulating factors, and (7) serial complete blood cell counts until the leukemoid reaction remitted...
September 1996: Journal of Pediatrics
F Raspall Torrent, J Soliva Garriga, X Demestre Guasch, X Sagrera Pelip, O Altirriba Valls, J Cubells Riero
Authors present three cases of leukemoid reaction in very low birth weight preterm infants. Hematologic evolution is detailed and was characterized by the presence of intense leukocytosis with marked shift to the left abundant immature forms. Leukocyte counts reached values of 70,000 and 106,000/mm3 between the second and third day of life, becoming normal around the eight day. No pathology known to cause such intense leukocytosis was observed in any case. Bibliography is reviewed and possible etiology is discussed, as until now this entity has been attributed to prenatal administration of glucocorticoids...
October 1987: Anales Españoles de Pediatría
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