[CIS PIDD] Chronic leukocytosis

[Wilmer Cordova Calderon]

Best regards, this a very difficult case because I dont have flow citometry
and others advances test

Here I sending all information that can have

Its a long time leukocytosis and hematology dont think in a malignancy (3
year with it)

The patient is eutrophic, but with  recurrent and chronic infections

Ill thanks a lot your suggestions and comment



Age: 3 years

female

Date of birth: March 31, 2009

BACKGROUND

Product of 2nd pregnancy

Cesarean delivery, 8 months, birth weight 2900 g

Fall of umbilical cord at 10 days

Complete Vaccines: up years of age.

The 1st hospitalization: 15 days old FEVER OVER PNEUMONIA (WBC 70 000), is
hospitalized for 1 month 15 days.

The 2nd hospitalization 1 year 2months, VIRAL BRONCHITIS (WBC 80 000),
hospitalized for 1 month

infections

Cellulite: 5 times: internal angle left eye, left elbow, right thigh,
vagina (2)

Otitis media: 4 times

Pneumonia: 1 time

Bronchitis 1 time

Sepsis: 2 times.

Apparently healthy relatives

Transfusion of red blood cells: once

Bone marrow aspirate 31/3/9, at the age of 1 year 11 months, without
alteration, NO leukemia

Final control of CBC:

Leukocytes (55 000)

Eosinof (2%)

Segm (75%)

Lymphatic (18%)

Mon (4%)

Hb (7.7)

Retic (0.4%)

Serum iron (35)

Transfer (273)

% Sat transf (12.8%)

Protein electrophoresis 29/11/11: Hypoalbuminemia. Polyclonal increase of
gamma globulin. Increased alpha 1 and 3.

DIAGNOSTICS:

Chronic leukocytosis:

Myeloproliferative syndrome. Leukocyte Adhesion Deficiency

Moderate chronic anemia - severe

Recurrent infection syndrome

Recurrent otitis media

Chronic otitis media left: fungal

recurrent cellulitis

chronic gingivostomatitis

Atopy: allergic rhinitis may


 HEMOGRAMA/FECHA









Recuento/Fecha

28/01/2011

15/02/2011

24/02/11

07/03/11

14/03/11

28/01/11

01/06/11

03/09/11

02/11/11

01/02/12

21/02/12

03/04/12

12/06/12

02/07/12

30/07/12

Leucocitos n° absoluto/células/μL

40200

23100

33800

28500

23400

40 200

23 960

50 500

30 280

66 390

33 100

28 800

43 460

36 380

55 000

Neutrófilos %/ células/μL

26130

14553

24336

20805

13338

26 532

15 094,8

32 825

19 984,8

53 775,9

28 135

19 296

31 291,2

27 285

44 000

Linfocitos % células/μL

12060

6930

6760

6270

7258

12 060

6 948,4

13 635

8 478,4

6 639

4 634

7 776

9 561,2

6 548,4

7 700

BASOFILOS

402

0

0

0

234

402

0

505

0

0

0

0

0

727,6

0

Monocitos

804

1383

1690

1425

2106

804

1 677,2

2 020

1 816,8

4 647,3

0

1 152

2 607,6

1 819

2 200

Eosinófilos

402

231

1014

0

234

402

239,6

1 515

0

1 327,8

331

576

1 100

Hemoglobina.

9.3

9.1

9.1

8.6

8.6

9,30

10,10

10,40

10,00

9,00

9,00

10,10

8,50

7,30

7,70

Hematocrito:

30

30

30

27

27

30

32

34

32

29

29

31

27

24

25

Plaquetas:

532

450

406

427

532 000

300 000

400 000

374 000

409 000

250 000

335 000

502 000

525 000

Elementos adicionales: RETICULOCITOS

0.9

2.7

1.2

0,9%

0,7%

1,4%

0,7%

0,8%

1,9%

1,5%

1,1%

1,90%

0,4%

*COMENTARIO*

*ALGUNOS HEMATIES FRAGMENTADOS*

LINFO ATIPICO 1%
      --
*Atte *
Wilmer Córdova
*Inmunología Alergología*
*Instituto Nacional de Salud del Niño - Perú*
http://www.isn.gob.pe
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