Emerson Geremiha, Kaide Colin G
Department of Emergency Medicine, Wexner Medical Center at The Ohio State University, 760 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210, USA.
Department of Emergency Medicine, Wexner Medical Center at The Ohio State University, 760 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210, USA.
Emerg Med Clin North Am. 2018 Aug;36(3):603-608. doi: 10.1016/j.emc.2018.04.005. Epub 2018 Jun 11.
Emergency providers are likely to encounter patients with acute and chronic leukemias. In some cases, the first presentation to the emergency department may be for symptoms related to blast crisis and leukostasis. Making a timely diagnosis and consulting a hematologist can be life saving. Presenting symptoms are caused by complications of bone marrow infiltration and hyperleukocytosis with white blood cell counts over 100,000. Presentations may include fatigue (anemia), bleeding (thrombocytopenia), shortness of breath, and/or neurologic symptoms owing to hyperleukocytosis and subsequent leukostasis. Treatment of symptomatic cases involves induction chemotherapy and/or leukapheresis. Asymptomatic hyperleukocytosis can be treated with hydroxyurea.
急诊医护人员很可能会遇到急性和慢性白血病患者。在某些情况下，患者首次到急诊科就诊可能是因为与原始细胞危象和白细胞淤滞相关的症状。及时做出诊断并咨询血液科医生可能会挽救生命。出现的症状是由骨髓浸润和白细胞计数超过10万的高白细胞血症并发症引起的。症状可能包括疲劳（贫血）、出血（血小板减少）、呼吸急促，和/或由于高白细胞血症及随后的白细胞淤滞导致的神经症状。有症状病例的治疗包括诱导化疗和/或白细胞单采术。无症状性高白细胞血症可用羟基脲治疗。
