Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (330 page)

   Chickenpox

   Smallpox

   Nephrotic syndrome (in some patients)

   Basophilopenia (No Lower Limit Can Be Determined Because Some Normal Subjects Have 0% Basophils)

   Hyperthyroidism

   Irradiation or chemotherapy

   Drugs: corticosteroids

   Ovulation and pregnancy

   Stress

LEUKEMOID REACTIONS

   Definition

A count >50,000/μL white cells in nonleukemic conditions defines a leukemoid reaction. The peripheral blood smear (PBS) shows increase in and shift to the left of myeloid cells (bands, metamyelocytes, myelocytes, some promyelocytes, and rare myeloblasts); increased primary granules in the myeloid cells (toxic granulation) and Döhle bodies, cytoplasmic vacuolization. If the left shift consists of an elevation of bands only (>700/μL), the term bandemia is applied. Frequently it signals the onset of a septic episode such as acute appendicitis.

   Causes of Leukemoid Reactions

   Severe sepsis (osteomyelitis, empyema, disseminated TB)

   Burns