Severe Leukocytosis With Neutrophilia (Leukemoid Reaction) in Alcoholic Steatohepatitis

Juturi, Jaya V.; Hopkins, Tamara; Farhangi, Mehdi

doi:10.1111/j.1572-0241.1998.1013a.x

Cited by 16 publications

(6 citation statements)

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“…90 A leukemoid reaction often is associated with infection, inflammation, malignancy, or use of drugs including glucocorticoids, psychiatric medications, and myeloid growth factors. [91][92][93][94][95][96][97][98][99] Therefore, patient history and findings on physical examination dictate whether further laboratory investigation is necessary to determine the cause of the increased WBC count. Further evaluation, if indicated, starts with a PBS that may show circulating blasts (suggesting acute leukemia), leukoerythroblastic results (suggesting myelofibrosis with myeloid metaplasia or other marrow-infiltrating process), or simply left-shifted neutrophilia.…”

Section: Granulocytosismentioning

confidence: 99%

How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults

Tefferi

Hanson

Inwards

2005

Mayo Clinic Proceedings

197

138

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A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. Therefore, it is in every clinician's interest to have some understanding of the specific test basics as well as a structured action plan when confronted with abnormal CBC results. In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.

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Section: Granulocytosismentioning

confidence: 99%

How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults

Tefferi

Hanson

Inwards

2005

Mayo Clinic Proceedings

197

138

View full text Add to dashboard Cite

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“…In line with these reports, our case illustrates the clinical and laboratory features of AH with LR, including markedly elevated leukocyte counts, characteristic peripheral smear findings, and severe liver dysfunction. Importantly, the prompt initiation of corticosteroid therapy, guided by established prognostic indicators such as the discriminant function score, was associated with a favorable outcome in our patient [ 6 - 10 ]. The pathophysiology of LR in AH remains incompletely understood but likely involves the dysregulated production of proinflammatory cytokines such as granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-α), and interleukins [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, the prompt initiation of corticosteroid therapy, guided by established prognostic indicators such as the discriminant function score, was associated with a favorable outcome in our patient [ 6 - 10 ]. The pathophysiology of LR in AH remains incompletely understood but likely involves the dysregulated production of proinflammatory cytokines such as granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-α), and interleukins [ 6 ]. These cytokines, released in response to liver injury and inflammation, promote the proliferation and differentiation of granulocyte precursors in the bone marrow.…”

Section: Discussionmentioning

confidence: 99%

The Leukemoid Reaction in Severe Alcoholic Hepatitis: A Case Report

Reddy,

Agrawal,

Kumar

et al. 2024

Cureus

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Alcoholic hepatitis (AH) is a clinicopathologic illness caused by excessive alcohol abuse and is a precursor of cirrhosis. The leukemoid reaction (LR) is characterized by a strikingly raised granulocyte count of 40,000-50,000 cells/mm 3 . The LR usually suggests an acute inflammatory reaction. It is usually mistaken for chronic myeloid leukemia. The initial phase of leukocytosis occurs due to the releasing of cells from the bone marrow with more immature cells, causing a left upper shift in the ratio of immature to mature neutrophils and macrophages. The LR is usually seen in cases of leukemia but is rare to present in alcohol hepatitis. Excessive alcohol use causes AH in persons with or without underlying chronic liver disease. In severe AH, leukemoid responses have been associated with very poor prognosis and short-term mortality. We describe a case of a 35-year-old male with severe AH with an LR.

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“…This case prompted us to review the literature describing this phenomenon. There were only a handful of case reports and case series describing a similar occurrence [ 6 - 8 ]. In a review of eight cases of patients with alcoholic hepatitis and associated leukemoid reaction, the white blood cell counts ranged from 57,000/uL to 129,000/uL.…”

Section: Discussionmentioning

confidence: 99%

Rare Case of Leukemoid Reaction in a Patient With Severe Alcoholic Hepatitis

Achufusi¹,

Sharma²,

Sapkota³

et al. 2020

Cureus

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Alcoholic hepatitis results from excessive alcohol consumption in patients with or without underlying chronic liver disease. Leukemoid reactions have been associated with poor outcomes in severe alcoholic hepatitis. There are only a handful of reported cases describing this relationship, and the striking similarity in these cases was a high short-term mortality rate. We believe that these patients represent a unique subgroup of patients with alcoholic hepatitis and that leukemoid reaction is a poor prognostic indicator in this condition. Here, we describe a case of 55-year-old male with severe alcoholic hepatitis with superimposed candida esophagitis who was found to have leukemoid reaction during diagnostic workup.

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Severe Leukocytosis With Neutrophilia (Leukemoid Reaction) in Alcoholic Steatohepatitis

Cited by 16 publications

References 1 publication

How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults

How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults

The Leukemoid Reaction in Severe Alcoholic Hepatitis: A Case Report

Rare Case of Leukemoid Reaction in a Patient With Severe Alcoholic Hepatitis

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