Background: In the course of managing preterm labour, increasing trends of total white cell count raises concern for the obstetrician, suggesting a possible underlying infectious aetiology. Although mild leukocytosis is expected in pregnancy, the patterns of increment after corticosteroid administration are not well described beyond animal models and in a small number of human studies. Methods: Seventy-three consecutive patients who required antenatal corticosteroids for either preterm labour or prelabour caesarean section were recruited and given a standard course of 12mg dexamethasone phosphate, twelve hours apart. Venous blood samples were taken before administration, at six hours and 36 hours after the first dose of dexamethasone. Results: The total white count trend was 10.31±2.62 at baseline, 11.44±3.05 at six hours and 12.20±3.49 at 36 hours. Neutrophil-lymphocyte ratio was 3.60±1.31, 8.73±3.63 and 3.24±1.49 respectively, reflecting relative neutrophilia and lymphopenia which normalised by 36 hours. Conclusion: In contrast to previous studies, we found only a slight increment in total white cell count of about 10%. The marginal changes described in our study would not normally raise any clinical concern, although vigilance should be exercised if higher levels were observed.
Leukocytosis ; Pregnancy

DRESS syndrome is an uncommon but potentially life-threatening subset of severe drug eruption characterized by fever, rash, leukocytosis with eosinophilia or atypical lymphocytosis, lymphadenopathy, and liver or renal dysfunction. The aromatic anticonvulsants (phenytoin, phenobarbital, carbamazepine) and sulfonamides are the most common cause of DRESS syndrome. Valproic acid, which is a widely used non-aromatic anticonvulsant, rarely causes DRESS syndrome. We report a case of DRESS syndrome in 47-year-old man caused by the use of valproic acid.
Anticonvulsants ; Drug Eruptions ; Eosinophilia ; Exanthema ; Fever ; Humans ; Leukocytosis ; Liver ; Lymphatic Diseases ; Lymphocytosis ; Middle Aged ; Phenobarbital ; Sulfonamides ; Valproic Acid

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory disease of the retina characterized by rapid loss of central vision, secondary to multiple flat yellow-whitish placoid lesions at the level of the pigment epithelium on the posterior pole. The fluorescein angiography demonstrates initial hypofluorescence in the lesion, where shows hyperfluorescence later. Usually, the central vision is recovered spontaneousely despite of permanent alterations in the pigment epithelium. The authors describe the clinical analysis of 19 cases of APMPPE treated at Department of Ophthalmology, Pusan Paik Hospital, Inje Medical college from January 1986 to July 1990. The results were as follows: 1) Ten cases(54%)occurred in the third decade. 2) Bilateral involvement occurred in 17 cases(90%) and 4 cases of those showed a different onset of symptoms in both eyes. 3) Nine cases(48%) occurred in the summer. 4) The symptoms of upper respiratory tract infection(URI) preceded by an average six days. 5) The symptoms of URI was indicated by 13 of the patients(68%). 6) Seventeen eyes(47%) showed uveitis as the combined ocular sign. 7) The lymphocytosis of cerebrospinal fluid was shown in four of eight cases(50%). In the complete blood count, leukocytosis was shown with 78% of all. 8) The visual acuity was below 0.4 in 83% of all at the time of presentation, and the final visual acuity was above 0.5 in 89% of all. 9) The visual acuity improved an average of eight weeks after the onset of symptoms.
Blood Cell Count ; Busan ; Cerebrospinal Fluid ; Epithelium ; Fluorescein Angiography ; Leukocytosis ; Lymphocytosis ; Ophthalmology ; Respiratory System ; Retina ; Uveitis ; Visual Acuity

OBJECTIVE: The aim of this research was to describe the epidemiologic, clinical laboratory and microbiologic characteristics, complications and outcome of pertussis among pediatric patients at the Philippine General Hospital.
METHODS: A retrospective chart review was performed which included pediatric patients with final diagnosis of pertussis, both clinical and laboratory -confirmed admitted from December 2012 to August 2013 at the Philippine General Hospital.
RESULTS: This chart review included 28 pertussis patients highest in those aged 1-3 months (86%), females (57%) and from region 4A (57%). 26 (93%) had exposure to household members with respiratory symptoms and unknown pertussis vaccination status. Of those patients who were eligible for vaccination, only 24% received age-appropriate DPT vaccination.
Onset of illness varied from 3-56 days; majority 9/L, range: 14.7-111.5x109/L;), lymphocytic predominance (mean lymphocyte 0.47, range: 0.20-0.72;) and thrombocytosis (mean platelet count: 567x109/L, range: 269-823x109/L;). 28% were culture positive for B. pertussis, while 86% tested positive for PCR.
The most common complications  were pneumonia requiring mechanical ventilation (64%), ARDS (28%), seizures (21%), nosocomial pneumonia (11%) and myocarditis (11%). The average length of hospital stay was 7.4 days with 13 deaths or 46% case fatality rate. Deaths were attributed to respiratory failure due to progressive pneumonia and ARDS. Other contributing causes were arrhythmia, MODS, and  septic shock.
CONCLUSION: Susceptible young infants acquire pertussis from household contacts with respiratory symptoms. Paroxysmal cough and cyanosis are common clinical features, with leukocytosis, lymphocytosis and thrombocytosis. High case fatality rate for pertussis was noted among these patients.

Human ; Male ; Female ; Infant ; Infant Newborn ; Whooping Cough ; Leukocytosis ; Lymphocytosis ; Cross Infection ; Bordetella Pertussis ; Thrombocytosis ; Respiratory Insufficiency ; Arrhythmias, Cardiac

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, medication-induced hypersensitivity reaction with long latency. It is characterized by fever, rash, leukocytosis with eosinophilia, atypical lymphocytosis, and internal organ involvement. The most common causes of DRESS syndrome are sulfonamides and anticonvulsants such as carbamazepine and lamotrigine. However, valproic acid and olanzapine could develop DRESS syndrome. We report a case of DRESS syndrome associated with valproic acid and olanzapine in a 41 years old male patient with bipolar disorder.
Anticonvulsants ; Bipolar Disorder* ; Carbamazepine ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Exanthema* ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Lymphocytosis ; Male ; Sulfonamides ; Valproic Acid*

Evans syndrome refer to autoimmune hemolytic anemia accompanied by thrombocytopenia. The etiologic factors of Evans syndrome are unknown but viral infections such as Epstein-Barr virus and cytomegalovirus are suggested. Epstein-Barr virus (EBV) infection is an acute illness characterized clinically by fever, sore throat, and lymphadenopathy; serologically by the transient positive heterophil antibody; and hematologically by mononuclear leukocytosis with atypical lymphocytosis. We experienced a case of Epstein-Barr virus infection presented as Evans syndrome. Epstein-Barr virus infection was diagnosed by positive heterophil antibody and EBV viral capsid antigen IgM. Autoimmune hemolytic anemia and immune thrombocytopenic purpura were completely resolved by steroid therapy.
Anemia, Hemolytic, Autoimmune ; Capsid ; Cytomegalovirus ; Fever ; Herpesvirus 4, Human* ; Immunoglobulin M ; Leukocytosis ; Lymphatic Diseases ; Lymphocytosis ; Pharyngitis ; Purpura, Thrombocytopenic, Idiopathic ; Thrombocytopenia

Pseudomembranous colitis (PMC) is highly prevalent in patients with broad spectrum antibiotic therapy. It can result in significant morbidity and mortality, especially if it is not diagnosed early. The clinical manifestation of PMC is diverse and symptoms usually are increased order of severity. Although leukocytosis is common, leukemoid reaction is very rare in PMC. We report a case of PMC associated with a leukemoid reaction without typical symptoms in a type 2 diabetic patient who have the multiple diabetic complications.
Clostridium difficile ; Diabetes Complications ; Diabetes Mellitus ; Enterocolitis, Pseudomembranous* ; Humans ; Leukemoid Reaction* ; Leukocytosis ; Mortality

BACKGROUND: Tuberculosis has commonly been associated with various hematologic changes. A difference between the changes found in pulmonary tuberculosis and those found in miliary tuberculosis has been discussed. Up to now some worker were investigated hematological changes associated with pulmonary tuberculosis but was not investigated those associated with miliary tuberculosis in korea. Therefore we examimed the peripheral blood and bone marrow findings in miliary tuberculosis patients to determine hematologic changes. METHODS: We performed blood sample at admission and bone marrow biopsy within 7days after admission. For evaluation of the hematologic findings, full blood counts and marrow differential counts were defined by the criteria outlined by Dacie and Lewis2). RESULTS: 1) Peripheral blood findings: Pancytopenia in 10% of patients, anemia in all patients, leukocytosis in 10% of patients, leukopenia in 20% of patients, thrombocytopenia in 30% of patients, lymphocytopenia in 90% of patients, monocytosis in 40% of patients and neutrophilia in 10% of patients were found at peripheral blood. 2) Bone marrow findings: Lymphocytopenia in 30% of patients, lymphocytosis in 20% of patients, plasmacytosis in 40% of patients, monocytosis in 100% of patients, and hypocellularity in 30% of patients were found at bone marrow. Erythropoiesis was decreased in 30% of patients. Granulopoiesis was decreased in 20% of patients and increased in 20% of patients. Bone morrow granuloma occured in 25% of patients. CONCLUSION: Hematologic changes of miliary tuberculosis were seen tendency of cytopenic pattern but monocyte was increased at peripheral blood and bone morrow. This findings would provide additional information for the differential diagnosis of miliary tuberculosis.
Anemia ; Biopsy ; Bone Marrow* ; Diagnosis, Differential ; Erythropoiesis ; Granuloma ; Hematology ; Humans ; Korea ; Leukocytosis ; Leukopenia ; Lymphocytosis ; Lymphopenia ; Monocytes ; Pancytopenia ; Thrombocytopenia ; Tuberculosis ; Tuberculosis, Miliary* ; Tuberculosis, Pulmonary

De novo B-cell prolymphocytic leukemia (B-PLL) is a distinct clinicopathologic entity that was first described in 1974 by Galton et al. B-PLL is characterized by marked lymphocytosis with predominance of prolymphocytes, often massive splenomegaly, minimal lymphadenopathy, often aggressive clinical course and frequently poor prognosis.We experienced a case of B-PLL associated with false-positive direct antiglobulin test. The patient was 52 year-old man who presented with marked leukocytosis (160.2x103/(mu)L) and 60% of characteristic prolymphocytes in the peripheral blood. The bone marrow aspirate showed dry tap and the PAS stain of peripheral blood smear showed positivity of prolymphocytes. The immunophenotyping of the leukemic prolymphocytes revealed the positivity of surface immunoglobulin (IgM, lambda type), HLA-DR, CD19 and CD5.
Bone Marrow ; Coombs Test* ; HLA-DR Antigens ; Humans ; Immunoglobulins ; Immunophenotyping ; Leukemia ; Leukemia, Prolymphocytic* ; Leukemia, Prolymphocytic, B-Cell ; Leukocytosis ; Lymphatic Diseases ; Lymphocytosis ; Middle Aged ; Splenomegaly

No abstract available.
Axons* ; Leukocytosis* ; Myelitis*