[CIS PIDD] Chronic leukocytosis
Sorensen, Ricardo
RSoren at lsuhsc.edu
Sat Aug 11 14:24:13 EDT 2012
Wilmer,
As you point out in your differential, this could be a form of LAD. When did his cord fall off?
I would Amos Etzioni for his opinion and advise directly: etzioni at rambam.health.gov.il
Ricardo Sorensen
From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Wilmer Cordova Calderon
Sent: Tuesday, August 07, 2012 2:46 AM
To: pagid at list.clinimmsoc.org
Subject: [CIS PIDD] Chronic leukocytosis
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 <http://www.isn.gob.pe/>
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