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The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation

Systematic glucocorticosteroids (GCS) are used to treat chronic obstructive pulmonary disease (COPD) and can cause leukocytosis. Distinguishing the effect of GCS on leukocyte level from infection-induced leukocytosis is important. We sought to quantify the effect of chronic GCS treatment on leukocyt...

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Autores principales: Frenkel, Amit, Kachko, Eric, Novack, Victor, Klein, Moti, Brotfain, Evgeni, Koyfman, Leonid, Maimon, Nimrod
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833099/
https://www.ncbi.nlm.nih.gov/pubmed/31623128
http://dx.doi.org/10.3390/jcm8101697
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author Frenkel, Amit
Kachko, Eric
Novack, Victor
Klein, Moti
Brotfain, Evgeni
Koyfman, Leonid
Maimon, Nimrod
author_facet Frenkel, Amit
Kachko, Eric
Novack, Victor
Klein, Moti
Brotfain, Evgeni
Koyfman, Leonid
Maimon, Nimrod
author_sort Frenkel, Amit
collection PubMed
description Systematic glucocorticosteroids (GCS) are used to treat chronic obstructive pulmonary disease (COPD) and can cause leukocytosis. Distinguishing the effect of GCS on leukocyte level from infection-induced leukocytosis is important. We sought to quantify the effect of chronic GCS treatment on leukocytosis level in patients with COPD exacerbation. We reviewed the records of patients with COPD exacerbation and fever hospitalized in a tertiary medical center in 2003–2014. Patients were classified according to the GCS treatment they received: chronic GCS treatment (CST), acute GCS treatment (AST), and no prior GCS treatment (NGCS). We used the eosinophil absolute count as a marker of compliance and efficacy of steroid treatment. The primary outcome was the maximal white blood cell (WBC) count within the first 24 h of admission. Of 834 patients, 161 were categorized as CST, 116 AST, and 557 NGCS. The overall maximal leukocyte count was higher and the eosinophil count lower in the two GCS therapy groups. In patients with COPD exacerbation and fever, acutely treated with GCS, the mean increase in the WBC count was more evident when the eosinophils were undetectable (absolute count of zero). This supports leukocytosis level as a marker of disease course in COPD and fever.
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spelling pubmed-68330992019-11-25 The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation Frenkel, Amit Kachko, Eric Novack, Victor Klein, Moti Brotfain, Evgeni Koyfman, Leonid Maimon, Nimrod J Clin Med Article Systematic glucocorticosteroids (GCS) are used to treat chronic obstructive pulmonary disease (COPD) and can cause leukocytosis. Distinguishing the effect of GCS on leukocyte level from infection-induced leukocytosis is important. We sought to quantify the effect of chronic GCS treatment on leukocytosis level in patients with COPD exacerbation. We reviewed the records of patients with COPD exacerbation and fever hospitalized in a tertiary medical center in 2003–2014. Patients were classified according to the GCS treatment they received: chronic GCS treatment (CST), acute GCS treatment (AST), and no prior GCS treatment (NGCS). We used the eosinophil absolute count as a marker of compliance and efficacy of steroid treatment. The primary outcome was the maximal white blood cell (WBC) count within the first 24 h of admission. Of 834 patients, 161 were categorized as CST, 116 AST, and 557 NGCS. The overall maximal leukocyte count was higher and the eosinophil count lower in the two GCS therapy groups. In patients with COPD exacerbation and fever, acutely treated with GCS, the mean increase in the WBC count was more evident when the eosinophils were undetectable (absolute count of zero). This supports leukocytosis level as a marker of disease course in COPD and fever. MDPI 2019-10-16 /pmc/articles/PMC6833099/ /pubmed/31623128 http://dx.doi.org/10.3390/jcm8101697 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Frenkel, Amit
Kachko, Eric
Novack, Victor
Klein, Moti
Brotfain, Evgeni
Koyfman, Leonid
Maimon, Nimrod
The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title_full The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title_fullStr The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title_full_unstemmed The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title_short The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation
title_sort association of glucocorticosteroid treatment with wbc count in patients with copd exacerbation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833099/
https://www.ncbi.nlm.nih.gov/pubmed/31623128
http://dx.doi.org/10.3390/jcm8101697
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