Leukemoid reactions occur in a variety of different conditions, all indicative of acute stress. These include infectious etiologies, adverse reactions to medications, asplenia, diabetic ketoacidosis, and septic shock with end-organ damage. Infants with trisomy 21 can often be born with a leukemoid reaction.
Leukemoid reactions will resolve with treatment of the underlying condition.
D72.823 – Leukemoid reaction
56478004 – Leukemoid reaction
- Hematologic malignancy – Peripheral smear will reveal dysplastic cell types.
- Infection – Tuberculosis, Clostridioides difficile colitis, pertussis, and mononucleosis from Epstein-Barr virus are most commonly associated with a leukemoid reaction. Visceral larva migrans can cause a leukemoid reaction but is associated with prominent eosinophilia.
- Ischemic hepatitis (see acute liver failure)
- Ischemic colitis
- Diabetic ketoacidosis
- Toxin ingestion or adverse drug reaction – Glucocorticoids, all-trans retinoic acid, dapsone, sulfa drugs, and ethylene alcohol intoxication are common causes.
- Paraneoplastic syndrome
- Acute blood loss anemia with hypovolemic shock – Retroperitoneal hemorrhage, gastrointestinal hemorrhage, trauma.
- Trisomy 21 – Newborn with leukemoid reaction on routine blood work.