Leukemoid reaction

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Summary of Leukemoid reaction

The term leukemoid reaction describes an increased white blood cell count, or leukocytosis, which is a physiological response to stress or infection as opposed to a primary blood malignancy, such as leukemia. It often describes the presence of immature cells such as myeloblasts or red blood cells with nuclei in the peripheral blood. It may be lymphoid or myeloid.

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Leukemoid reaction

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Leukemoid reaction

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A 56-year old Caucasian man comes to the emergency department because of severe fatigue, mild fever, and lightheadedness. His medical history is relevant for a very recent hospitalization. Upon further revision of his medical records, you find out that the patient was discharged from the hospital 2-days ago because of a resolved gastrointestinal infection. On physical examination, the patient is pale and has mild splenomegaly. His temperature is 37.8°C (99.6°F), pulse is 102/min, respirations are 26/min, and blood pressure is 110/60 mmHg. Laboratory studies show increased leukocytosis (50,000/mm3) with increased neutrophilic precursor dominance and increased leukocyte alkaline phosphatase. Bone marrow aspiration is hypercellular but otherwise unremarkable. Which of the following is the most likely diagnosis?

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