An update on the etiology and diagnostic evaluation of a leukemoid reaction

Vissaria Sakka; Sotirios Tsiodras; Evangelos J Giamarellos-Bourboulis; Helen Giamarellou

doi:10.1016/j.ejim.2006.04.004

An update on the etiology and diagnostic evaluation of a leukemoid reaction

Eur J Intern Med. 2006 Oct;17(6):394-8. doi: 10.1016/j.ejim.2006.04.004.

Authors

Vissaria Sakka¹, Sotirios Tsiodras, Evangelos J Giamarellos-Bourboulis, Helen Giamarellou

Affiliation

¹ 4th Department of Internal Medicine, University General Hospital "ATTIKON", 1 Rimini Street, 124 62 Athens, Greece.

PMID: 16962944
DOI: 10.1016/j.ejim.2006.04.004

Abstract

Persistent neutrophilic leukocytosis above 50,000 cells/muL when the cause is other than leukemia defines a leukemoid reaction. The diagnostic work-up consists of the exclusion of chronic myelogenous leukemia (CML) and chronic neutrophilic leukemia (CNL) and the detection of an underlying cause. The major causes of leukemoid reactions are severe infections, intoxications, malignancies, severe hemorrhage, or acute hemolysis. The present article points out the difficulties in the differential diagnosis of a leukemoid reaction and suggests an algorithm for a rational clinical and laboratory evaluation of this problematic entity.