A clinical case of leuckemoid reaction in newborn with congenital pneumonia
A. P. Khokhlova,
H. A. Sarkisyan,
Y. V. Zhirkova,
T. S. Kurina,
E. E. Melkumyan,
L. A. Vanyan,
L. M. Makarova,
M. M. Nasser,
O. V. Tsilinskaya,
P. V. Shumilov https://doi.org/10.22627/2072-8107-2025-24-1-56-62
Abstract
Being a rather rare, but at the same time extremely important finding in the general blood test, the leukemoid reaction (LR) is a short-term sharp increase in the level of leukocytes above 30—50 x 109/l with a shift of the leukocyte formula to the left. The development of this condition may be due to a number of factors, but in pediatric practice, LR is primarily associated with prematurity, the course of the infectious process (most often pneumonia), extremely low body weight, taking certain medications both by the mother during pregnancy and by the child, chromosomal abnormalities and others. Of particular importance to the study of LR is the fact that similar changes in peripheral blood are observed in a number of other diseases, including the course of malignant processes — leukemia, which requires a competent approach to differential diagnosis, the involvement of various specialists and makes LR an exception diagnosis.
About the Authors
A. P. Khokhlova
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
H. A. Sarkisyan
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation; Children’s City Clinical Hospital No. 9 named after G.N. Speransky
Russian Federation
Russian Federation
Moscow
Y. V. Zhirkova
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation; Children’s City Clinical Hospital No. 9 named after G.N. Speransky
Russian Federation
Russian Federation
Moscow
T. S. Kurina
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
E. E. Melkumyan
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
L. A. Vanyan
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
L. M. Makarova
Children’s City Clinical Hospital No. 9 named after G.N. Speransky
Russian Federation
Russian Federation
Moscow
M. M. Nasser
Children’s City Clinical Hospital No. 9 named after G.N. Speransky
Russian Federation
Russian Federation
Moscow
O. V. Tsilinskaya
Children’s City Clinical Hospital No. 9 named after G.N. Speransky
Russian Federation
Russian Federation
Moscow
P. V. Shumilov
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Moscow
References
1. Neonatology: national guide: in 2 volumes. Vol. 1. ed. N.N. Volodin, D.N. Degtyarev. 2nd ed., processed and additional. Moscow: GEOTAR-Media, 2023:752. (In Russ.)
2. Bhatia R., Bhatia G. Neonatal Leukemoid Reaction: A Diagnostic Dilemna. Journal of Nepal Paediatric Society. ,2017; 36(3):298. DOI:10.3126/jnps.v36i3.15611
3. Portich J.P., Faulhaber GAM. Leukemoid reaction: A 21st-century cohort study. Int J Lab Hematol. 2020 Apr; 42(2):134—139. DOI: 10.1111/ijlh.13127.
4. Viner E., Berger J, Bengualid V. Etiologies of Extreme Leukocytosis. Cureus. 2023 Apr 24; 5(4):e38062. DOI: 10.7759/cureus.38062.
5. Krumbhaar E.B. Leukemoid blood pictures in various clinical conditions. Am J Med Sci. 1926; 172:519—33.
6. Hsiao R., Omar SA. Outcome of extremely low birth weight infants with leukemoid reaction. Pediatrics. 2005 Jul; 116(1): e43—51. DOI: 10.1542/peds.2004-1379.
7. Kuo Y.C., Huang CY, Ng CCY, Lin CY, Huang WK. Paraneoplastic leukocytosis induces NETosis and thrombosis in bladder cancer PDX model. Am J Cancer Res. 2024 Aug 25; 14(8):3694—3710. DOI: 10.62347/IHIO5742.
8. Posado-Domínguez L., Figuero-Pérez L, Olivares-Hernández A, et al. Paraneoplastic leukocytosis secondary to carcinosarcoma: a report of two cases and literature review. Chin Clin Oncol. 2024; 13(3):42. DOI:10.21037/cco-23-146
9. Samad M.A., Mahboob E, Mansoor H. Chronic myeloid leukemia: a type of MPN. Blood Res. 2022 Jun 30; 57(2):95—100. DOI: 10.5045/br.2022.2021173.
10. Widén J., Jönsson G, Karlsson U. Mycoplasma pneumonia with severe cold agglutinin hemolysis, thrombocytosis, leukemoid reaction and acute renal failure. IDCases. 2023; 31:e01689. Published 2023 Jan 13. DOI:10.1016/j.idcr.2023.e01689
11. Sánchez L.D., Domínguez L.P. Neonatal leukemoid reaction due to early-onset neonatal sepsis in a premature infant. A case report. Revista Médica Del Hospital General De México. 2015. DOI:78. 10.1016/j.hgmx.2015.08.008.
12. Holland P., Mauer M.A. Myeloid leukemoid reactions in children. Am J Dis Child. 1963 Jun; 105:568—75. DOI: 10.1001/archpedi.1963.02080040570007.
13. Torrent F & Soliva Garriga, Joan & Guasch, Xavier & Pelip, X & Valls, O & Riero, J. Leukemoid reactions in premature neonates with a very low birth weight. Anales Еspañoles de Рediatría. 1987; 27:244—8.
14. Shao Q.Q., Qin L, Ruan GR, Chen RX, Luan ZJ, Ma XJ. Tigecycline-induced Drug Fever and Leukemoid Reaction: A Case Report. Medicine (Baltimore). 2015 Nov; 94(45):e1869.DOI: 10.1097/MD.0000000000001869.
15. Cohen A., Barak M, Herschkowitz S, Zecca S. Leukemoid reaction induced by prenatal administration of betamethasone. Acta Paediatr Jpn. 1993 Dec; 35(6):534—6. DOI:10.1111/j.1442-200x.1993.tb03104x.
16. Nakamura T, Hatanaka D, Kusakari M, et al. Neonatal Leukemoid Reaction with Fetal Inflammatory Response Syndrome Is Associated with Elevated Serum Granulocyte Colony Stimulating Factor and Interleukin-6. Tohoku J Exp Med. 2018; 244(2):145—149. DOI:10.1620/tjem.244.145
17. Terry C., Kane D, Eogan M, McCallion N, Doyle E, Drew RJ. Retrospective analysis of leukemoid reactions in extremely preterm infants in a tertiary NICU from 2018—2021. J Matern Fetal Neonatal Med. 2023; 36(2):2225115. DOI:10.1080/14767058.2023.2225115
18. Liu R., Huang Y, Jia Z, Joseph MJ, Chai K. Elevated serum AST and LDH levels are associated with infant death in premature babies with neonatal leukemoid reaction: a cohort study. Transl Pediatr. 2022 Dec; 11(12): 1920—1927. DOI: 10.21037/tp-22-543.
19. Jumanne S., Nyundo A. A case of a 22-month-old boy with necrotizing pneumonia presenting with leukaemoid reaction misdiagnosed as leukaemia: a case report and review of the literature. Malawi Med J. 2019; 31(3): 223—226. DOI:10.4314/mmjv31i3.10
20. Kishkun A.A. Laboratory research in neonatology. Moscow: GEOTAR-Media, 2022:592. (in Russ.)
21. Hoofien A., Yarden-Bilavski H, Ashkenazi S, Chodick G, Livni G. Leukemoid reaction in the pediatric population: etiologies, outcome, and implications. Eur J Pediatr. 2018 Jul; 177(7):1029—1036. DOI: 10.1007/s00431-018-3155-5.
22. Feng M.T., Ji Q, Liu DD, Xu W. Two cases of Leukemoid reaction in premature infants caused by fetal inflammatory response syndrome. BMC Pediatr. 2024 Aug 24; 24(1):546. DOI: 10.1186/s12887-024-05006-4.
23. Kakkat S.M., Lakra MS, Lakhar B, Jain A, Reddy RM. An Unusual Presentation of Neonatal Sepsis as Hyperleukocytosis with Firm Lymphadenopathy: A Diagnostic Challenge. Cureus. 2022; 14(10)e30454. Published 2022 Oct 19. doi:10.7759/cureus.30454
24. Jung E., Romero R, Yeo L, Diaz-Primera R, Marin-Concha J, Para R. The fetal inflammatory response syndrome: the origins of a concept, pathophysiology, diagnosis, and obstetrical implications. Semin Fetal Neonatal Med. 2020 Aug; 25(4):101146. DOI: 10.1016/j.siny.2020.101146.
25. Hematology: national guide edited by prof. O.A. Rukavitsin. GEOTAR-Media, 2019:1722. (In Russ.)
26. Brown P.A. Neonatal Leukemia. Clin Perinatol. 2021 Mar; 48(1):15—33. DOI: 10.1016/j.clp.2020.11.002
Review
For citations:
Khokhlova A.P., Sarkisyan H.A., Zhirkova Y.V., Kurina T.S., Melkumyan E.E., Vanyan L.A., Makarova L.M., Nasser M.M., Tsilinskaya O.V., Shumilov P.V. A clinical case of leuckemoid reaction in newborn with congenital pneumonia. CHILDREN INFECTIONS. 2025;24(1):56-62. (In Russ.) https://doi.org/10.22627/2072-8107-2025-24-1-56-62
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