Gulen Huseyin, Basarir Filiz, Hakan Nilay, Ciftdogan Dilek Yilmaz, Tansug Nermin, Onag Ali
Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology.
Haematologica. 2005 Nov;90 Suppl:ECR38.
Leukoerythroblastosis is a rarely observed disease characterized by the presence of leukocytosis, erythroid and myeloid blast cells in peripheral blood. To our knowledge, it had not been diagnosed in a premature newborn before the case we report have.A female baby weighing 1164 grams, who was born prematurely at the 29th week of gestation by Cesarean section was referred to our newborn intensive care unit due to prematurity and respiratory distress with no prenatal pathological findings. Physical examination revealed tachypnea and hepatosplenomegaly. Routine laboratory measurements showed significant leukocytosis (85,000/mm3) and anemia (Hb: 9.6 g/dL and Hct: 27.6%). The platelet count was normal. The peripheral blood smear suggested leukoerythroblastosis with the presence of nucleated erythrocytes, monocytosis, and 4% blasts. Bone marrow cytogenetic examination was normal. Parvovirus B19 Ig G and M serology were detected to be positive. The etiological factors observed in leukoerythroblastosis occurring during neonatal and early childhood period are congenital-postnatal viral infections, juvenile myelomonocytic leukemia and osteopetrosis. To our knowledge, no case of leukoerythroblastosis in such an early phase has been reported in the in literature. As a result, premature delivery and leukoerythroblastosis were thought to have developed secondary to intrauterine parvovirus B19 infection. Leukoerythroblastosis is a rarely observed disease characterized by the presence of leukocytosis, erythroid and myeloid blast cells in peripheral blood. It is reported that it can be observed following hematologic malignancies especially juvenile myelomonocytic leukemia, acute infections, hemolytic anemia, osteopetrosis, myelofibrosis, neuroblastoma and taking certain medicines. To our knowledge, it has not been diagnosed in a premature newborn before. Here we the case of a newborn who was referred to our intensive care unit due to being born prematurely at the 29th week of gestation and diagnosed with leukoerythroblastosis.
白红血细胞增多症是一种罕见疾病,其特征为外周血中存在白细胞增多、红系和髓系原始细胞。据我们所知,在我们报告的病例之前,尚未有早产新生儿被诊断为此病。一名体重1164克的女婴,在妊娠第29周时通过剖宫产早产,因早产和呼吸窘迫被转诊至我们的新生儿重症监护病房,产前无病理检查结果。体格检查发现呼吸急促和肝脾肿大。常规实验室检查显示白细胞显著增多(85,000/mm³)和贫血(血红蛋白:9.6 g/dL,血细胞比容:27.6%)。血小板计数正常。外周血涂片提示存在有核红细胞、单核细胞增多症及4%的原始细胞,符合白红血细胞增多症表现。骨髓细胞遗传学检查正常。检测到细小病毒B19 IgG和M血清学呈阳性。在新生儿期和儿童早期发生的白红血细胞增多症中观察到的病因包括先天性 - 产后病毒感染、青少年型骨髓单核细胞白血病和骨质石化症。据我们所知,文献中尚未报道过如此早期阶段的白红血细胞增多症病例。因此,认为早产和白红血细胞增多症是继发于宫内细小病毒B19感染。白红血细胞增多症是一种罕见疾病,其特征为外周血中存在白细胞增多、红系和髓系原始细胞。据报道,在血液系统恶性肿瘤尤其是青少年型骨髓单核细胞白血病、急性感染、溶血性贫血、骨质石化症、骨髓纤维化、神经母细胞瘤以及服用某些药物后可观察到该病。据我们所知,此前尚未有早产新生儿被诊断为此病。在此,我们报告一例因在妊娠第29周早产而被转诊至我们重症监护病房并被诊断为白红血细胞增多症的新生儿病例。