Moderate Leukocytosis Research Articles

Chronic myeloid leukemia with thrombocythemic onset may be associated with different BCR/ABL variant transcripts

Ph-positive chronic myeloid leukemia (CML) mimicking essential thrombocythemia (ET) at onset seems to be a distinct clinical entity. Whether this rare clinical form of CML is associated with single, specific variants of BCRIABL transcripts is a matter of debate. Among 82 consecutive patients with Ph-positive CML, we identified 3 patients in which the disease mimicked ET at presentation, because of marked thrombocytosis and moderate leukocytosis, with few immature myeloid cells in peripheral blood and blood basophilia in 2 of them. Molecular analysis with the reverse transcriptase-polymerase chain reaction technique showed the presence of b2a2, b3a2, and b3a2-b2a2 transcript variants in the three patients, respectively. The results of our study together with a review of literature data suggest that different BCRIABL transcript variants may occur in CML mimicking ET, without an apparently significant prevalence of one type.

Engrafted maternal T cells in human severe combined immunodeficiency: Evidence for a T H2 phenotype and a potential role of apoptosis on the restriction of T-cell receptor variable β repertoire

1. Street MD, Donovan GR, Baldo BA, Sutherland S. Immediate allergic reactions to Myrmecia ant stings; immunochemical analysis of Myrmecia venoms. Clin Exp Allergy 1994;24:590-7. 2. Donovan GR, Baldo BA, Sutherland S. Molecular cloning and characterisation of a major allergen (Myr p 1) from the venom of the Australian jumper ant. Biochim Biophys Acta 1993;1171:272-80. 3. Weiner JM, Baldo BA, Donovan GR, Sutherland SK. Allergy to jumper ant (Myrmecia pilosula) stings in south-eastern Australia [abstract]. Ann Allergy Asthma Immunol 1995;74:60. 4. Stuckey M, Cobain T, Sears M, Cheney J, Dawkins RL. Bee venom hypersensitivity in Busselton [letter]. Lancet 1982;2:41.

Clinical and laboratory alterations in horses during immunization with snake venoms for the production of polyvalent (Crotalinae) antivenom

Six horses were immunized with the venoms of Bothrops asper, Crotalus durissus durissus and Lachesis muta stenophrys for the production of polyvalent (Crotalinae) antivenom. During the immunization, clinical and laboratory alterations were evaluated in these animals, and the development of humoral immune response was followed. Only moderate local tissue changes (edema, abscesses, fistules and fibrosis) were observed in these animals, whereas no systemic alterations occurred. Regarding laboratory tests, there was a drop in hemoglobin concentration and hematocrit, together with an increment in total serum protein. Horses developed a moderate leukocytosis, with increments in polymorphonuclear leukocytes and lymphocytes. No significant changes were observed in prothrombin time or platelet count. There were no alterations in serum lactic dehydrogenase and gamma glutamyl transferase activities, whereas minor increments in creatine kinase and alanine aminotransferase activities were observed, together with a decrease in aspartate aminotransferase. All these changes occurred after the injection of 9 mg venom, when sodium alginate was first used as adjuvant. Creatinine levels had a small increment, although no changes were observed in urea levels or in the urea creatinine ratio. An important individual variability was observed in the humoral immune response, as judged not only by enzyme-linked immunosorbent assay, but also by assessing the neutralization of the indirect hemolytic activity of venoms.

Leukocyte kinetics in the blood of mice with alloxan-induced diabetes

An autoradiographic kinetic study of neutrophilic leukocytes, monocytes, and lymphocytes from the peripheral blood of male BALB/c mice with subacute diabetes induced by alloxan showed that the diabetes was accompanied by moderate neutrophilic leukocytosis, monocytopenia, depressed monocytopoiesis, prolonged circulation times of neutrophils and monocytes, and a shortened circulation time of lymphocytes.

Clozapine serum levels and side effects during steady state treatment of schizophrenic patients: a cross-sectional study

Serum clozapine (S-Cloza) and serum desmethyl-clozapine concentrations (S-Descloza) were measured in 30 chronic schizophrenic in- and out-patients on a variable dose regimen. All patients were in steady state with respect to clozapine therapy and in a stable condition with respect to psychotic illness. The 24-h clozapine dose (median with interquartile range in parenthesis) was 350 (228-425) mg/24 h (range 100-700). There was a weak positive correlation between doses and the BPRS total score (r = 0.44, P < 0.05). The median S-Cloza was 1076 (706-1882) nmol/l (range 196-5581 corresponding to 64-1824 ng/ml). The S-Cloza was linearly correlated to dose but with a high interindividual variation at equal doses, e.g. a factor of 8 at 400 mg/24 h, but a low intraindividual variability of 20%. The S-Descloza averaged 77% of the S-Cloza and was highly correlated to S-Cloza (r = 0.90; P < 0.001). The S-Descloza/dose ratio increased with age and duration of treatment. The side effects registered were EEG abnormalities (83%), tachycardia (23%), increased liver enzyme activity (60%), orthostatic hypotension (17%), and moderate leucocytosis (17%). Only EEG changes were correlated to S-Cloza (r = 0.43; P < 0.05). The score values of the UKU Side Effect Scale were weakly (r = 0.36) correlated to S-Cloza. No side effects were correlated to S-Descloza, doses, or treatment duration. The frequency of side effects was higher than in studies using lower mean doses indicating a correlation between doses or S-Cloza and the frequency of side effects. It is concluded that clozapine fulfils the criteria for therapeutic drug monitoring. TDM may contribute to finding the lowest effective dose with the fewest possible side effects.

Unique clinical features and prognostic significance of the translocation (6;11) in acute leukemia

A translocation (6;11)(q26–27;q23) was detected in four male patients diagnosed with acute T-cell lymphoblastic leukemia and acute myelomonocytic and monocytic leukemias. This acquired reciprocal translocation appears to be associated with acute leukemias in young men who present clinically with localized infection, and a moderate leukocytosis. There was a poor response to antileukemic chemotherapy and a short overall survival. Aggressive treatment strategies should be considered in the treatment of these high-risk leukemias.

Cytometric and cytochemical study of peritoneal and alveolar macrophages from Yersinia pseudotuberculosis infected ground squirrels (Citellus citellus).

The enzymic activity (succinate dehydrogenase, acid and alkaline phosphatase) of alveolar and peritoneal macrophages as well as leucocytic reaction of ground squirrels infected with Yersinia pseudotuberculosis (I and III serovar) have been investigated in dynamics from the 1st up to the 30th day. The animals infected with III serovar survived only to the 7th day, while those infected with I serovar survived up to the 30th day after inoculation. A massive influx of leucocytes having peak values (100-fold increase) on the 3rd day after infection has been found in the peritoneal cavity of the animals infected with I serovar. Moderate leucocytosis in the blood, and insignificant fluctuations in alveolar macrophage number have been established too. An earlier and higher activation of succinate dehydrogenase in alveolar and peritoneal macrophages from animals infected with III serovar in comparison with those infected with I serovar was observed. No differences in alkaline phosphatase activity of alveolar and peritoneal macrophages have been found between the animals infected with I and III serovar. A correlation has been found between the number of leucocytes and changes in the enzymatic activity of the macrophages. A metabolic transformation was demonstrated typical for different macrophages (peritoneal and alveolar), in the course of this experimental intraperitoneal infection. Obviously, more virulent serovar III of Y. pseudotuberculosis fails to attract leucocytes to the peritoneal cavity sufficiently quickly, so it overcome the local protective mechanisms with consequent systemic cytochemical changes. On the other hand the virulent serovar I attracts leucocytes to the peritoneum and is presumably destroyed by them.

The effects of acute moderate exercise on leukocyte and lymphocyte subpopulations

The extent and duration of changes in circulating leukocyte and lymphocyte subpopulations, cortisol, and catecholamines were examined in 12 women who walked 45 min at 60% VO2max in a laboratory setting. A two-factor, 2 x 6 design with repeated measures on both factors was utilized. The first factor was condition (exercise and rest), and the second factor was time (six points of measurement over a 24-h period), with treatment order counterbalanced. The 45-min walk, in comparison with rest in a seated position, was associated with a significant but moderate leukocytosis and lymphocytosis immediately following the walk. The leukocytosis was still evident after 3 h of recovery and was primarily due to a neutrophilia. The change in lymphocyte count, relative to baseline levels and the control condition, lasted less than 1.5 h, with an increase in the natural killer (CD16 and/or CD56) and cytotoxic T cell component (CD3 and CD16 and/or CD56) (NKCT) representing approximately two-thirds of the lymphocytosis and T cells (CD5) the other third. A significant decrease in the CD4:CD8 ratio was seen, with cytotoxic/suppressor (CD8) cells increasing and helper/inducer (CD4) cells demonstrating little change in comparison with baseline. This seems to have been due to a subpopulation of CD8 (low density antigen) cells, probably natural killer cells. The 45-min walk had no effect on plasma cortisol and epinephrine levels relative to the rest condition but was associated with a moderate increase in norepinephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

Synovial Leukocytosis in Infectious Arthritis

The clinical presentation of 41 adult patients with infectious arthritis has been reviewed with special emphasis on initial synovial fluid leukocytosis. Fifty percent of the patients with culture-proven joint-space infections had synovial fluid leukocyte counts below 28,000/mm3. Comparison of this investigation with previous studies of similar magnitude demonstrates a striking difference in the mean and median synovial fluid white cell counts. The population reviewed had a higher incidence of patients with potentially immunocompromising medical conditions than previous reports. Similarities between this and previous reports include predisposing conditions, the spectrum of pathogens cultured, associated clinical findings on admission, hospital course, and mortality. The data presented here document the magnitude of potential overlap between the synovial fluid leukocytosis in infected joints and in joints afflicted with other forms of inflammatory arthropathy. Three patients populations (malignant neoplasms, steroid use, and intravenous drug abuse) with positive cultures from synovial fluid aspirates but initial synovial fluid white cell counts averaging below 50,000 cells/mm3 were identified. Patients with moderate synovial fluid leukocytosis, especially those potentially immunocompromised, must be considered to have infectious arthritis unless other causes of inflammatory arthropathies are demonstrated.

A CASE OF PREOPERATIVELY DIAGNOSED GALLSTONE ILEUS

Gallstone ileus is a relatively rare complication of cholelithiasis and it is hardly diagnosed preoperatively. This paper describes a such case in which we could successfully diagnosed preoperatively, together with a review of about 200 cases in the Japanese literature. A 66-year-old male was admitted because of a half-day history of abdominal pain with nausea on June 6, 1988. He had moderate leukocytosis and his abdomen was slightly distended with mild tenderness at the epigastrium. Abdominal plain X-ray films revealed a small bowel obstruction, air in the gallbladder and a oval-shaped calcificated mass of which position was changed daily on it. The upper G-I series showed a cholecystoduodenal fistula and an impacted gallstone in the terminal ileum. Laparotomy was carried out under a diagnosis of gallstone ileus 7 days after the admission. The impacted stone, measured 5×3×3cm, was milked back from the terminal ileum and was removed through enterotomy. Cholecystectomy and closure of the cholecystoduodenal fistula were performed. Postoperative course was uneventfull.

Essential thrombocythemia. Clinical characteristics and course of 61 cases.

Sixty-one patients with essential thrombocythemia (ET) were followed from 1974 through 1987 at the Medizinische Poliklinik. Fifty-one patients (84%) presented with thromboembolic complications, and eight patients (13%) with hemorrhages. In seven patients (12%), a thrombocytosis was detected accidentally. Disturbances of the microcirculation (67%), mainly of the fingers and toes (53%), were the most frequent thromboembolic symptoms. The mean age of all patients was 58 years (male patients, 61 years; female patients, 56 years). The average platelet count at diagnosis was 897,000/microliter. The average maximal platelet count was 1.231 X 10(6)/microliter (range, 500,000/microliter to 4 X 10(6)/microliter). Seventy-two percent had a moderate leukocytosis (average, 12,400/microliter), 34% a splenomegaly, 29% a hepatomegaly. Signs of hypermetabolism were infrequent, lactate dehydrogenase (LDH) and uric acid elevations, if present, were moderate. Bleeding time and viscosity were normal in most patients. Spontaneous platelet aggregation was increased in 81% of patients (n = 40). Platelet aggregation studies with the aggregation inducing substances adenosine diphosphonate (ADP), platelet activating factor (PAF), thrombin, collagen, and adrenalin showed hypoaggregation in most patients. Adrenalin-induced aggregation distinguished best between ET-patients and reactive thrombocytosis showing hypoaggregation in all ET-patients tested (n = 16) and in none of 22 controls. Bone marrow studies were performed in 57 patients. The histologic studies (done in 49 patients) were consistent with a chronic myeloproliferative disorder in all cases. In 41 cases (84%) the picture of a megakaryocytic myelosis was found, in 12 of these a granulocyte-rich form of megakaryocytic myelosis. Cytologic studies only (eight patients) did not differentiate ET well from reactive thrombocytosis. Platelet aggregation studies and bone marrow histology may be of help in the diagnosis of difficult cases of thrombocytosis. The Philadelphia status was negative in all cases studied (14 patients). Fourteen patients died. The causes of death were thromboembolic complications in probably 11 and acute leukemia in two patients. The probability of 10-year survival is 64% after a mean follow-up time of approximately 5 years. It appears that considering the average age of ET patients at diagnosis, life expectancy is close to normal.

Hematological findings in the Norrbottnian type of Gaucher disease.

A controlled study of hematological changes was performed on 14 patients with the Norrbottnian type of Gaucher disease, seven of whom had been splenectomized at least one year before the study. Each patient had two controls matched to age, sex and habitation. Before splenectomy the patients had slight to moderate microcytic, hypochromic anemia which changed after splenectomy to macrocytic, hypochromic anemia. The splenectomized patients had a high percentage of target cells (mean frequency 33%) and a significantly increased hypo-osmotic resistance of the erythrocytes which showed a positive correlation with the number of target cells. Before removal of the spleen the patients had slight leukopenia with a relative increase of mononuclear cells and moderate thrombocytopenia. In the splenectomized patients the thrombocyte count was normal and there was moderate leukocytosis with a persistent relative increase of lymphocytes.

Susceptibility of immunodeficient mice to challenge infection with histoplasma capsulatum

Groups of mice were neonatally thymectomized and treated with antithymocyte serum (ATS) prior to challenge infection with viable yeast phase (YP) Histoplasma capsulatum G-17M. Moderate leucocytosis and moderate lymphopenia were seen in immunodeficient animals after infection. Surviving immunodeficient mice exhibited low levels of migration inhibition activity, while peritoneal exudate cells and spleen cells harvested from surviving infected and untreated normal mice showed significant migration inhibition in the presence of histoplasmin antigen. The LD50 values for YP cells of H. capsulatum were 1.1 x 10(6) for normal untreated mice, 6.0 x 10(5) for thymectomized mice, and 6.3 x 10(5) for ATS-treated mice. Thymectomized mice that also received ATS treatment exhibited an LD50 of 1.7 x 10(5) and were 6.5 times more susceptible to infection then normal mice. Mice which were either thymectomized or treated with ATS were 1.7 times as susceptible as normal mice to infection with H. capsulatum. The criterion of susceptibility is a decrease in the LD50 value.

St Louis Encephalitis in Ohio, September 1975

In 1975, during the largest epidemic of St Louis encephalitis (SLE) in the United States, 416 cases were diagnosed in Ohio. Persons who were admitted to two Columbus (Ohio) hospitals with suspected acute viral CNS infection were prospectively studied to define the virologic and clinical aspects of SLE. Sixteen cases of SLE were diagnosed serologically. Fifteen patients had signs of encephalitis and one had aseptic meningitis. Six patients had the syndrome of inappropriate antidiuretic hormone secretion. Other frequent findings included moderate peripheral leukocytosis and CSF pleocytosis, with mild elevation of CSF protein levels but normal glucose levels. Severe neurologic sequelae were infrequent. The EEG proved valuable in diagnosis and prognosis. Results of brain scans were normal. Virus in CSF or urine was not demonstrated, nor was viral antigen in CSF or urine sediments. Specific antibody was found in the sera and CSF of all patients who were tested, but interferon was not detected.

Legionnaires' Disease: Clinical Features of the Epidemic in Philadelphia

A review of the medical records of 123 persons with Legionnaires' disease hospitalized in the 1976 Philadelphia epidemic showed that the manifestations of infection ranged from mild grippe to a severe pneumonia that also involved other organ systems. Early in the illness, constitutional symptoms predominated. Fever, malaise, myalgia, rigors, confusion, headache, and diarrhea were usually followed by nonproductive cough and dyspnea. Physical examination showed few abnormalities other than rales. Moderate leukocytosis with left shift, elevated erythrocyte sedimentation rate, elevation of serum levels of liver enzymes, and hematuria and proteinuria were characteristic. Chest radiograph showed patchy, often nodular, areas of consolidation. Progression of pneumonia led to respiratory failure and the need for mechanical ventilatory assistance for 19 patients; renal failure, primarily after shock, occurred in 18 persons. Twenty-six patients died. Treatment with erythromycin or tetracycline resulted in the lowest case-fatality ratios, but the associations were not statistically significant.

Babesiosis in Long Island

The effects of splenectomy and size of inoculum on response of hamsters to three isolates of Babesia microti (two rodent- and one human-derived) from Long Island were studied. Splenectomy of hamsters did not enhance susceptibility to the rodent isolates of B. microti at a dosage of 5 X 10(7) parasites. Larger parasite inocula produced shorter prepatent periods and slightly shorter duration of infection in intact hamsters. Inoculum size was not contributory to mortality of hamsters or to pathogenesis. Hamsters showed profound anemia with depressed hematocrit and hemoglobin values and erythrocyte counts. Moderate leucocytosis was seen just prior to peak parasitemia, with immature polymorphonuclear cells predominating. Infections in hamsters lasted for 14--17 weeks. As determined by the parameters studied, the three isolates appear to be identical.

Legionnaires' Disease: Diagnosis and Management

Diagnosis and Treatment1 March 1978Legionnaires' Disease: Diagnosis and ManagementAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-3-363 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail AbstractAbstractLegionnaires' disease, an acute bacterial infection commonly manifested as pneumonia, has recently been recognized in outbreaks and sporadic cases. Most documented cases have occurred during the summer and in middle-aged or older persons. Clues to the diagnosis include nonproductive cough, pleuritic chest pain, diarrhea, and confusion. Moderate leukocytosis and nodular consolidation typically are seen on chest roentgenograms. Diagnosis may be made by culture of the fastidious Gram-negative bacillus from lung tissue or pleural fluid, demonstration of the organism in lung tissue by the direct fluorescent antibody technique, or documentation of a significant rise in serum titer by indirect fluorescence. Erythromycin is recommended for therapy.

Unusual Foreign Bodies in Bowel

History A 19-year-old man was brought into the emergency department in a stuporous state. Shortly after arrival, he had a grand mal seizure and vomited several times. He was admitted for observation. Examination showed a lethargic, sweating young man with slight abdominal tenderness and guarding. There were no other abnormal physical findings. Laboratory tests showed a moderate polymorphonuclear leukocytosis. There were decreased amplitude of T waves in all electrocardiographic leads and prominent U waves. A chest roentgenogram was normal. Blood gases indicated respiratory alkalosis. Ventilatory assistance was required during his ten-day hospital stay, during which time evidence of a respiratory infection developed, which cleared promptly on treatment. An abdominal roentgenogram (Figure) was taken on admission. Diagnosis Cocaine bags in the colon. Comment Multiple oval soft-tissue densities, each highlighted by a gas halo, are visible along the course of the colon and elsewhere in the abdomen in the Figure. These are

Effect of Streess on Blood Leucocyte and Milk Somatic Cell Counts in Dairy Cows

Blood and milk samples from Holstein cows were examined for total blood leucocyte count, differential blood leucocyte count, milk quality test, and somatic cell count in milk while the cows were stressed by corticotropin injection, confinement in a heat-humidity chamber, or environmental-heat stress by exposure during the hot summer months of June through November in southern Arizona. All three stressing conditions resulted in a moderate blood leucocytosis. Modest increases in somatic cell counts of milk were associated with corticotropin injection and environmental-heat stress. Positive correlations were recorded between blood leucocytes and somatic cell counts of milk in mastitis-free cows injected with corticotropin and between percent blood neutrophils and somatic cell counts of milk in environmental-heat stressed cows with no evidence of current mastitis.

Toxicologic studies of the hormonal form of vitamin D 3: Acute and subacute toxicity of 1α-hydroxycholecalciferol

Toxicologic examination of 1α-hydroxycholecalciferol (1α-HCC) revealed its acute toxicity to be high, and the sex variation in sensitivity of the rat to be slightly different. In subacute toxicity studies in rats, body weight gain was extremely inhibited in the animals which received 12.5, 25 and 50 μg/kg. Urinalysis revealed higher calcium concentration in the urine of experimental groups while excretion of urinary phosphate was reduced in the rats receiving 12.5, 25 and 50 μg/kg. Proteinuria was seen in rats of 12.5 μg/kg and higher dose groups. Blood cell counts showed moderate leukocytosis in the higher dose groups than in the 12.5 μg/kg group. Laboratory tests in blood indicated that plasma calcium concentration, total protein, total cholesterol, and blood urea nitrogen in the 12.5-μg/kg and higher dose groups were elevated significantly. Though scattered histological changes were seen in the kidney, heart, aorta, testes, thymus, lung, liver, thyroid, and intestinal mucosa. The main action of 1α-HCC was recognized in the necrosis of the intima of the arteriole in the heart, in digestive tracts and in voluntary muscles, resulting from the degeneration and fibrosis of muscles. However, all those lesions which were caused by the administration of 1α-HCC were fully reversible after 50 days in the recovery group. In rats, oral administration of 2.5 μg/kg of 1α-HCC for 30 days was considered to be a nontoxic dose under the conditions of this experiment.