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PubMed2000

Is leukocytosis a predictor of mortality in severe pertussis infection?

Bordetella pertussis causing severe respiratory failure in infants that is unresponsive to treatment is well described. Pulmonary hypertension is a prominent feature of such cases. In this series of 13 critically ill infants with B. pertussis, hyperleukocytosis ( > 100 x 10(9)/l) was an independent predictor of death. We suggest that such extreme leukocytosis may contribute to disease severity via the formation of aggregates in the pulmonary vasculature.

Blood Gas Analysis↗
PubMed2006

HLA-B67 may be a male-specific HLA marker of susceptibility to relapsed childhood ALL in Hong Kong Chinese and HLA-A33 or HLA-B17 signifies a higher presentation leukocytosis: A retrospective analysis on 53 transplant candidates (1989-2003).

We performed a retrospective analysis on the human leukocyte antigen (HLA) data of 53 consecutive Chinese patients with high-risk childhood acute lymphoblastic leukemia (ALL) diagnosed from 1989 to 2003. A significantly higher frequency of HLA-B67 in the male relapse group of patients [OR, 23.08; 95% CI, 5.31-100.36; p = 0.0042; for statistical significance after Bonferroni correction (Bc) p (Bc) < 0.0083] was identified after Bonferroni correction. Although not surviving the Bonferroni correction, gender effects on the association were also observed with HLA-A11, HLA-A32, HLA-A33, and HLA-B22, which were however more prevalent in the female patients and particularly those developing relapse. Two patients with HLA-A29 and HLA-B7 revealed significantly shortened survivals, suggestive of their potential prognostic impacts. Notably, for the first time, we found a significant correlation of leukocyte count with HLA types, where HLA-A33 (p = 0.006) or HLA-B17 (p < 0.001) signifies higher leukocytosis at presentation. Taken together, our findings support the involvement of HLA in Chinese high-risk childhood ALL.

Adolescent↗
PubMed1998

Abnormal physiological conditions in acute schizophrenic patients on emergency admission: dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes.

This study investigated varieties and incidence of abnormal physiological conditions in acute schizophrenic patients on emergency. Laboratory data obtained prior to treatment from patients, admitted on an emergency basis during an 18-month period, were evaluated retrospectively, as well as demographics and clinical characteristics. Of 259 male acute schizophrenic patients (ICD-10: F2), 6.9% revealed dehydration, a third had hypokalemia and leukocytosis, and two thirds showed elevated serum muscle enzymes. These percentages were statistically significant compared with those of outpatients. In addition, the former three of these conditions in the F2 group were as frequent as those in alcohol and/or psychoactive substance abusers (ICD-10: F1) on emergency admission, although elevated serum muscle enzymes in the F2 group was less frequent than that in the F1 group. In order to prevent these abnormal physiological conditions from worsening and becoming life-threatening, one fourth of the F2 group [dehydration, 6.9%, severe hypokalemia (< 3.0 mEq/l), 2.3%, and markedly elevated serum muscle enzymes (creatine phosphokinase > 1000 IU/l), 16.5%] required medical management such as fluid therapy and various types of monitoring. In cases of a behavioral emergency, laboratory screening and monitoring of urinary output were essential. Due to their lack of cooperation, case history, physical examination, and initial vital signs did not contribute to detection of their medical condition.

Acute Disease↗
PubMed1976

Marked cyclic leukocytosis-leukopenia in chronic myelogenous leukemia.

A spontaneous oscillation of the white blood cell count was observed in a 58 year old man with chronic myelogenous leukemia (CML). Similar cyclic variations were noted in the platelet and reticulocyte counts with no apparent alterations in marrow cellularity to account for such changes. Since direct correlation was noted between white blood cells, platelets, and reticulocyte counts versus spleen size, it suggests that splenic hemopoiesis may be responsible for these cyclic changes. A possible inverse relationship between colony-stimulating factor (CSF) activity and the white blood cell count was noted, suggesting that CSF may be the humoral agent controlling granulocyte production. A direct correlation between the white blood cell count and serum unsaturated vitamin B12 binding capacity (UBBC) and lysozyme was also noted and further supports the concept that the latter two are measures of the granulocyte pool and metabolism. An inverse relationship between CSF activity and the UBBC suggests that these may be two different entities. Finally a modified form of standard chemotherapy may be effective in inducing remission in cases of CML with marked cyclic leukocytosis-leukopenia.

Alkaline Phosphatase↗
PubMed1985

Suppression of leukocytosis by the intrauterine delivery of high doses of indomethacin in the rat.

Studies were undertaken in rats to determine the intrauterine rate of release of high doses of indomethacin incorporated into Silastic rods. It was found that at a 28% w/w loading an 1X0.1 cm rod would exponentially deliver the drug at an average of 35 micrograms/day for the first 2 weeks; by 70 days the rate had declined to 6.5 microgram/day. After being present for 31 days, these types of medicated rods were found to reduce the numbers of luminal leukocytes when compared with the numbers obtained from uterine horns containing plain, non-medicated rods. Despite the reduction in leukocytosis, implantation was prevented by the high dose of indomethacin.

Animals↗
PubMed1987

Relationship between leukocytosis and ischemic complications following aneurysmal subarachnoid hemorrhage.

The prognostic significance of admission leukocytosis with respect to ischemic complications of subarachnoid hemorrhage was retrospectively investigated in a series of patients with recently ruptured intracranial aneurysms. The present study concerned 47 consecutive cases admitted within 72 hours following the last hemorrhage, in the years 1982-1984. There was no difference in the admission WBC counts between patients who subsequently deteriorated due to ischemic complications and those who did not. However, the cell count rose significantly at the time of the clinical manifestations of ischemia, possibly as a result of structural damage of brain tissue and/or increased sympathetic and adrenocortical activity. The possible contribution of leukocytes to the pathogenesis of ischemic damage following subarachnoid hemorrhage--perhaps through the release of leukotrienes--will require further investigation.

Female↗
PubMed1991

Leukocytosis at the onset of diabetes in crosses of inbred BB rats.

Inbred lymphopenic, diabetes-prone (DP) and non-lymphopenic, diabetes-resistant (DR) BB rats in a specific pathogen-free (SPF) colony were subjected to a cross-intercross breeding experiment which showed diabetes to segregate as a recessive trait. All DP rats, but none of the DR and F1 rats, developed diabetes. In contrast, about 25% of the F2 rats developed diabetes which made it possible to study these rats without maternal influence of diabetes. All rats were bled at regular intervals between 30 and 150 days of age, and the samples analyzed for numbers of leukocytes, lymphocytes, neutrophils, monocytes and eosinophils. Leukocyte numbers tended to increase with age until about 100 days, and to decline thereafter. Males had more leukocytes than females. Coinciding with the time of onset of overt diabetes, there was a large increase in eosinophils, along with smaller increases in neutrophils, monocytes and lymphocytes. These data in SPF DP and DR BB rats and their cross-intercross offspring demonstrate that the overt onset of diabetes is associated with a significant leukocytosis.

Aging↗
PubMed1979

Purification of leukocytosis-promoting substance from bovine parotid gland extract.

A leukocytosis-promoting substance was purified from a crude bovine parotid gland extract. The purified substance was proved to be a single component by polyacrylamide gel disc electrophoresis. It stimulates an increase of peripheral leukocyte numbers in rabbits. The molecular weight of the physiologically active component was estimated to be 4.5 . 10(4), and the component was found by sodium dodecyl sulfate polyacrylamide gel electrophoresis to be dissociated into two subcomponents.

Animals↗
PubMedDate not supplied

Smoking-induced leukocytosis can persist after cessation of smoking.

BACKGROUND: Associations between smoking and leukocytosis or elevated hemoglobin concentrations in the blood need to be validated using multivariate analysis. METHODS: A total of 2,511 male subjects aged 25-62 years participated in an annual health examination held at their workplace. The relationship between white blood cells (WBC) and hemoglobin (Hb) levels in blood and smoking status was then evaluated using a cross-sectional survey and multiple logistic regression analysis. Age, body mass index (BMI), smoking and drinking status, diastolic blood pressure, and physical activity were used as covariate factors. RESULTS: Odds ratios (ORs) and 95% confidence intervals (95% CIs) of WBC of >9,000 counts/mm3 of total blood for current smokers and ex-smokers with a period of 5-9.9 years since smoking cessation vs. that of nonsmokers were 12.1 (7.0-21.0) and 3.8 (1.2-12.0), respectively. OR (95% CI) of Hb level >16 g/dL of total blood for current smokers vs. nonsmokers was 1.6 (1.1-2.3). Significant ORs for elevated Hb level in total blood were also observed for age (OR, 1.0; 95% CI, 0.9-1.0), BMI >25 (OR, 2.2; 95% CI, 1.6-3.1), and diastolic blood pressure of >90 mmHg (OR, 2.2; 95% CI, 1.5-3.2). CONCLUSIONS: Current smoking is associated with increase in WBC count and Hb levels in total blood, the former relationship recognized in subjects who have stopped smoking for 5-9.9 years. Obesity and aging are inversely related with Hb level in blood.

Adult↗
PubMedDate not supplied

Early leukocytosis in trauma patients: what difference does it make?

OBJECTIVE: To determine the association of the admission white blood cell count in trauma patients with demographics, severity and mechanism of injury, and need for therapeutic intervention. METHODS: Evaluation of prospectively collected registry data (admissions to a Level I trauma center in 2001). Differences in mean white blood cell count on admission were evaluated with t tests. Multiple linear regressions were performed with forward stepwise selection of variables. RESULTS: Of the 882 patients admitted for greater than 24 hours, white blood cell count was available for 786. Variations in white blood cell count were noted on bivariate analysis among different races, injury mechanisms and severities, Glasgow Coma Scores, blood pressures, and between patients requiring early transfusions versus those who did not. No difference was noted between patients who went to the operating room in the first 24 hours versus those who did not, or for patients who died in the hospital. On multiple linear regression analyses, only ISS greater than 15, GCS less than or equal to 8, and white race were associated with increases in white blood cell count. Leukocytosis was found not to be associated with mechanism of injury, specific organ injury, shock on admission, or the need for transfusion or surgery. CONCLUSION: Variations in white blood cell count in trauma patients are associated with race and injury severity, but they are not beneficial in predicting the need for volume resuscitation, transfusion, or surgery.

Female↗
PubMed2006

Relationship of CSF leukocytosis to compartmentalized changes in MCP-1/CCL2 in the CSF of HIV-infected patients undergoing interruption of antiretroviral therapy.

Although monocyte chemoattractant protein (MCP-1)/CCL2 is believed to mediate trafficking of HIV-activated leukocytes into the CNS, its role has not been studied directly in humans. To evaluate MCP-1's effects on CNS leukocyte infiltration, we measured CSF leukocytes and MCP-1 levels in serial plasma and cerebrospinal fluid (CSF) samples from subjects who experienced large increases in viral load after interrupting antiretrovirals. Following large increases in CSF MCP-1, CSF leukocytosis (15-166 cells/microL) developed in 4 of 6 subjects. Both initial MCP-1 levels and subsequent changes were 3-fold larger in CSF than plasma. The magnitude and timing of changes suggested that MCP-1 triggers the development of CSF pleocytosis.

Adult↗
PubMed1998

The duration of febrile seizures and peripheral leukocytosis.

In 203 consecutive children with febrile seizures, no clear association (odds ratio = 1.0 [95% CI, 0.9-1.1], P = .59) was found between seizure duration and blood leukocytosis (> or = 15.0 x 10(9) cells/L). Increased leukocyte counts may be misinterpreted because of seizure duration. In children with febrile seizures, leukocyte counts should be used to evaluate the underlying cause of fever.

Bacterial Infections↗
PubMed2002

NPY modulates epinephrine-induced leukocytosis via Y-1 and Y-5 receptor activation in vivo: sympathetic co-transmission during leukocyte mobilization.

Sympathetic nervous system (SNS) activation mobilizes blood leukocytes. Under these circumstances, both epinephrine (EPI) and neuropeptide Y (NPY) are released. Therefore, we investigated a possible interaction between these transmitters during leukocyte mobilization, using intravenous catheterization of male adult Lewis rats. Intravenous application of NPY followed by EPI, dose-dependently facilitated, intensified and inhibited EPI-induced leukocytosis with subset-specificity for NK-cells, monocytes, and B-lymphocytes. Pharmacological assessment of NPY receptors involved revealed a Y-1R-mediated inhibition and a Y-5R-mediated facilitation. RT-PCR on peripheral blood mononuclear cells (PBMC) detected Y-1R mRNA only, suggesting direct Y-1R-mediated effects on leukocytes and indirect effects via the Y-5R. Thus, via a specific Y-1R/Y-5R interplay, NPY acts as a neuroimmune co-transmitter in vivo.

Animals↗
PubMed1998

The molecular basis of leukocytosis.

The function of any known gene is often found by DNA or protein homology scanning. Conversely, it is equally rewarding to search for the genetic basis behind a known function. Here, Ghislain Opdenakker and colleagues examine the known and possible novel genes and molecular events underlying the phenomenon of leukocytosis, one of the most common clinical manifestations of inflammatory problems.

Humans↗
PubMed1982

Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.

Elevation of the corrected leukocyte count (Cwbc) in peritoneal lavage effluent has been reported by us in association with colon perforation. We have extended this study in order to investigate systematically the nature of the stimuli to, and the timing, magnitude, and consistency of this response in the presence of other occult abdominal injuries associated with trauma. This has been done by subjecting an anesthetized canine model to a variety of isolated intra-abdominal injuries and then measuring sequential peritoneal lavage leukocyte counts up to six hours after injury. A rising lavage leukocyte count gave Cwbc-positive lavages in 94% of animals with jejunal, ileal, and colonic wounds by six hours. In animals with isolated peritoneal penetration alone, or simple liver or spleen wounds, an elevated Cwbc count was unusual. In stomach, gallbladder, and urinary bladder perforation, a positive lavage was an inconsistent finding. Peritoneal lavage leukocyte counts corrected on the basis of red cell count can enhance the accuracy and utility of lavage for abdominal trauma, especially when gastrointestinal perforation is present as an isolated injury, by detecting an early peritoneal inflammatory response which appears independently from simple hemorrhage. [Mueller GL, Burney RE, MacKenzie JR: Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.

Abdominal Injuries↗
PubMed1989

The leukocyte esterase test for detection of cerebrospinal fluid leukocytosis and bacterial meningitis.

We conducted a study to assess the efficacy of the dipstick leukocyte esterase test (LET) in the detection of cerebrospinal fluid (CSF) leukocytosis as a quick screen for bacterial meningitis. Nine hundred forty-two CSF samples were collected from 800 patients. The LET was compared in a double-blinded fashion with routine cell count determinations and cultures. We reviewed the clinical courses of all patients with positive cultures to assess the significance of culture isolates. Statistical analysis revealed LET sensitivity of 84.4% and specificity of 98.1% for clinical presentations of bacterial meningitis for which initiation of therapy is currently recommended. The LET identified culture-proven cases of meningitis with sensitivity of 73% and specificity of 95%. We propose the LET as an adjunct to, but not a replacement for, CSF cell count and chemistry determination in the initial laboratory assessment of bacterial meningitis. It is a reasonable screen that allows rapid initiation of treatment and directs the laboratory technician to devote extra attention to examination of a CSF specimen with a higher likelihood of pathology.

Adolescent↗
PubMed2002

The role of forced swim test on neutrophil leukocytosis observed during inflammation induced by LPS in rodents.

Adult male rats were administered intrapleural (ipl) or intraperitoneal (i.p.) injection of lipopolysaccharide (LPS), 24 h after being submitted to forced swim test (FST). Four hours after LPS challenge, an increase in pleural and peritoneal leukocyte and neutrophil counts in animals not exposed to FST was noted. FST induced a marked increase in pleural, but not in peritoneal, neutrophil leukocytosis. The results suggest that lowered mood may increase inflammatory response to LPS.

Animals↗