Leukemoid reaction in the pediatric population: etiologies, outcome, and implications.
Eur J Pediatr
; 177(7): 1029-1036, 2018 Jul.
Article
em En
| MEDLINE
| ID: mdl-29696475
Leukemoid reaction (WBC > 30,000/µL) may indicate significant medical conditions, mostly infectious. Prompted by the lack of population-based data on the presentation, characteristics, and necessary workup in children with leukemoid reaction, we searched the database of a tertiary pediatric medical center for all children presented with at least one WBC count of ≥ 30,000/µL in 2009-2014. Demographic, clinical, and laboratory parameters were recorded. Children admitted with WBC < 30,000/µL served as controls. Pneumonia was the most common diagnosis in the leukemoid reaction group, with a 5.5-fold higher prevalence of pleuropneumonia than in the control group. The leukemoid group had a longer average hospital stay (7.5 vs. 5.5 days). Patients with WBC ≥ 50,000/µL had a sixfold higher rate of leukemia than patients with a lower count. There was a significant association of leukemia with low platelet count, low levels of C-reactive protein, and high levels of uric acid and lactate dehydrogenase. CONCLUSION: Children presented with a leukemoid reaction are at high risk of pneumonia, especially pleuropneumonia, and a long hospital stay. Those with WBC ≥ 50,000/µL have a sixfold higher risk of leukemia. For prompt diagnosis, clinicians should be aware of the variables associated with leukemia. What is Known: ⢠Leukemoid reaction has been associated with infectious diseases. ⢠Leukemoid reaction at presentation in adults is correlated with high morbidity and mortality. What is New: ⢠Children with leukemoid reaction are at high risk of pleuropneumonia. ⢠We did not observe increased mortality in children with a leukemoid reaction.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reação Leucemoide
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Contagem de Leucócitos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article