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Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report

Leukemoid reaction (increase in leucocyte count >50 ×10(9) cell/l) occurs due to reactive causes of bone marrow and is diagnosed after excluding the malignant haematological disorder. Leukemoid reaction is a rare clinical presentation in metastatic renal cell carcinoma and is said to have a rare...

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Autores principales: Khatiwada, Pramit, Yadav, Girendra, Guragain, Prashant, Raut, Pradip, Subedi, Viplaw, Dulal, Soniya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129231/
https://www.ncbi.nlm.nih.gov/pubmed/37113841
http://dx.doi.org/10.1097/MS9.0000000000000513
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author Khatiwada, Pramit
Yadav, Girendra
Guragain, Prashant
Raut, Pradip
Subedi, Viplaw
Dulal, Soniya
author_facet Khatiwada, Pramit
Yadav, Girendra
Guragain, Prashant
Raut, Pradip
Subedi, Viplaw
Dulal, Soniya
author_sort Khatiwada, Pramit
collection PubMed
description Leukemoid reaction (increase in leucocyte count >50 ×10(9) cell/l) occurs due to reactive causes of bone marrow and is diagnosed after excluding the malignant haematological disorder. Leukemoid reaction is a rare clinical presentation in metastatic renal cell carcinoma and is said to have a rare prognosis. This case has had been reported in the line of SCARE criteria. CASE PRESENTATION: A case of a 35-year-old female with no known previous co-morbidities presented with a history of abdominal pain in the right flank region for 2 months, fever and cough for 2 months. Physical examination showed palpable mass and tenderness in the right flank and investigations showed leukemoid reaction in peripheral blood smear. The patient was initially treated with strong intravenous antibiotics with suspicion of pyelonephritis in another centre, despite which the patient still had elevated leucocyte count and referred to our centre, where the patient was evaluated for elevated leucocyte count and with further investigations, ruled out any malignant haematological disorder. Final diagnosis of renal cell carcinoma was made by renal mass biopsy. The patient underwent targeted therapy with sunitinib. The patient expired and further investigation and follow-up were not possible. CONCLUSION: The lack of data and evidence of extensive diagnostic tests is the reason we are unable to assume leukemoid reaction as a poor prognostic factor in case of metastatic renal cell carcinoma. The presence of other paraneoplastic syndromes with renal cell carcinoma might have resulted in the poor prognosis that cannot be excluded.
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spelling pubmed-101292312023-04-26 Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report Khatiwada, Pramit Yadav, Girendra Guragain, Prashant Raut, Pradip Subedi, Viplaw Dulal, Soniya Ann Med Surg (Lond) Case Reports Leukemoid reaction (increase in leucocyte count >50 ×10(9) cell/l) occurs due to reactive causes of bone marrow and is diagnosed after excluding the malignant haematological disorder. Leukemoid reaction is a rare clinical presentation in metastatic renal cell carcinoma and is said to have a rare prognosis. This case has had been reported in the line of SCARE criteria. CASE PRESENTATION: A case of a 35-year-old female with no known previous co-morbidities presented with a history of abdominal pain in the right flank region for 2 months, fever and cough for 2 months. Physical examination showed palpable mass and tenderness in the right flank and investigations showed leukemoid reaction in peripheral blood smear. The patient was initially treated with strong intravenous antibiotics with suspicion of pyelonephritis in another centre, despite which the patient still had elevated leucocyte count and referred to our centre, where the patient was evaluated for elevated leucocyte count and with further investigations, ruled out any malignant haematological disorder. Final diagnosis of renal cell carcinoma was made by renal mass biopsy. The patient underwent targeted therapy with sunitinib. The patient expired and further investigation and follow-up were not possible. CONCLUSION: The lack of data and evidence of extensive diagnostic tests is the reason we are unable to assume leukemoid reaction as a poor prognostic factor in case of metastatic renal cell carcinoma. The presence of other paraneoplastic syndromes with renal cell carcinoma might have resulted in the poor prognosis that cannot be excluded. Lippincott Williams & Wilkins 2023-04-12 /pmc/articles/PMC10129231/ /pubmed/37113841 http://dx.doi.org/10.1097/MS9.0000000000000513 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Case Reports
Khatiwada, Pramit
Yadav, Girendra
Guragain, Prashant
Raut, Pradip
Subedi, Viplaw
Dulal, Soniya
Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title_full Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title_fullStr Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title_full_unstemmed Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title_short Leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in Nepal: a case report
title_sort leukemoid reaction in a patient with metastatic renal cell carcinoma—rare clinical presentation seen in nepal: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129231/
https://www.ncbi.nlm.nih.gov/pubmed/37113841
http://dx.doi.org/10.1097/MS9.0000000000000513
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