Leukemoid-Like Reaction in a Post-Coronary Artery Bypass Grafting Surgery Patient
DOI:
https://doi.org/10.51253/pafmj.v76i1.12565Keywords:
Coronary Artery Bypass, Extracorporeal Circulation, Immune Response, Leukocytes, Leukemoid ReactionAbstract
A leukemoid reaction in post-cardiac surgery is uncommon. Few cases in the literature have reported a leukemoid-like reaction; furthermore, there are only a handful in cardiac surgery. The diagnosis of leukemoid reactions can be problematic for physicians. Even though leukemoid reactions are benign, in severe cases, excessive white blood cells can lead to tissue damage. Additionally, fatal conditions like malignancies can present similarly. Therefore, it is necessary to perform broad laboratory investigations. We present a case of a patient who had significant postoperative hyperleukocytosis following coronary artery bypass grafting (CABG). Various investigations were performed to rule out any sinister cause, like post-operative infections and malignancy; however, they came out negative. Furthermore, she did not develop any signs or symptoms during her stay or after discharge, and she was diagnosed with a leukemoid-like reaction and progressed to a good outcome. This case highlights the importance of avoiding unnecessary investigations and treatment, especially in resource-limited settings.
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References
1. Hoffman R. Hematology: Basic Principles and Practice. 4th ed. Elsevier Churchill Livingstone; 2005. Available from:
https://doi.org/10.1016/B978-0-443-06619-3.X5001-6
2. Robinson WA. Granulocytosis in Neoplasia. Ann N Y Acad Sci 1974; 230(1): 212-218.
https://doi.org/10.1111/j.1749-6632.1974.tb20531.x
3. Sakka V, Tsiodras S. Update on Etiology and Diagnostic Evaluation of Leukemoid Reaction. Eur J Intern Med 2006; 17(6): 394-388. https://doi.org/10.1016/j.ejim.2006.03.013
4. Halkes CJ, Dijstelbloem HM, Eelkman Rooda SJ, Kramer MH. Extreme Leucocytosis: Not Always Leukemia. Neth J Med 2007; 65(7): 248-251. https://doi.org/10.1016/S0300-2977(07)70117-6
5. Tanner TG, Colvin MO. Pulmonary Complications of Cardiac Surgery. Lung 2020; 198(6): 889-896.
https://doi.org/10.1007/s00408-020-00393-9
6. Krumbhaar EB. Leukemoid Blood Pictures in Clinical Conditions. Am J Med Sci 1926; 172(4): 519-532.
https://doi.org/10.1097/00000441-192610000-00005
7. Granger JM, Kontoyiannis DP. Etiology and Outcome of Extreme Leukocytosis. Cancer 2009; 115(17): 3919-3923.
https://doi.org/10.1002/cncr.24444
8. Padmakumar G, Ravikrishnan J, Jayakumar P, Prasad K. Leukemoid-like Reaction in Post-CABG Patient. Indian J Anaesth 2014; 58(3): 315. https://doi.org/10.4103/0019-5049.130794
9. Drury NE, Ali A, Mussa S, Webb ST, Rege KP, Wallwork J. Acute Leukaemoid Reaction Following Cardiac Surgery. J Cardiothorac Surg 2007; 2: 1-3.
https://doi.org/10.1186/1749-8090-2-1
10. Portich JP, Faulhaber GA. Leukemoid reaction: A 21st‐century cohort study. Int J Lab Hematol 2020; 42(2): 134-139.
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Copyright (c) 2026 Usman Ahmad, Maheen Sheikh, Junaid Ahmed Khan, Iqbal Alam Khan

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