A Clinico-Hemaological Study of Cases of Leucoerythroblastic Reaction

  • Tejaswini Waghmare Seth GS Medical College and KEM Hospital, Mumbai, India
  • Daksha Prabhat Seth GS Medical College and KEM Hospital, Mumbai, India
  • Naveen Vairamoorthy D Seth GS Medical College and KEM Hospital, Mumbai, India
Keywords: Hematology, Leucoerythroblastic reaction, Peripheral Blood Smear

Abstract

Background: Leucoerythroblastic Reaction (LER) is defined as the presence of immature red cells and immature white cells of the myeloid series in peripheral blood. Literature has revealed various causes for LER, which include hemolyticanemia, infections, megaloblastic anemia, liver diseases and others. Objectives: To study the hematological changes, especially peripheral blood smear (PBS) findings in LER cases. Methods: A total number of 100 consecutive cases which revealed LER on peripheral blood smear (PBS) were included in this study. Various hematological parameters such as. hemoglobin, total leucocyte count, platelet count as obtained from the automated blood cell counter and PBS findings were analysed. Results: In the present study, majority of the cases (30%) were in the age range of 21 to 30 years, with equal gender distribution. Anemia was seen in 87% of the cases, leucocytosis in 79% and thrombocytopenia in 60%. Polychromasia with increased reticulocytes was noted in 55% of the cases. Nucleated RBCs were noted in all cases. All cases showed shift to left in the myeloid series. Commonest cause of LER encountered was hemolytic disease (29%) followed by liver diseases (22%) and septicemia (18%). Conclusion: The present study emphasizes various etiologies of LER and the importance of reporting LER in PBS. Examination of peripheral blood smear for morphology of RBCs, WBCs and platelets gives a clue to the etiology.

Author Biographies

Tejaswini Waghmare, Seth GS Medical College and KEM Hospital, Mumbai, India
Department of Pathology
Daksha Prabhat, Seth GS Medical College and KEM Hospital, Mumbai, India
Department of Pathology
Naveen Vairamoorthy D, Seth GS Medical College and KEM Hospital, Mumbai, India
Department of Pathology

References

1. Vaughan JM, Oxon DM. Leuco-erythroblasticanemia. Journal of Pathology and Bacteriology. 1936; 42(3):541–564.
2. Byard RW, Bormanis J, Jones TG. Leukoerythroblastosis: a much maligned phenomenon?. CMAJ. 1987; 137(3):191.
3. Lazar GS, Forman SJ: Leukoerythroblastic reaction in Still disease in an adult. West J Med 1972;131:152-155
4. Retief F. Leuco-erythroblastosis in the adult. The Lancet. 1964; 283(7334):639–642.
5. Clifford GO. The clinical significance of leukoerythroblastic anemia. The Medical Clinics of North America. 1966; 50(3):779.
6. Canbolat Ayhan A, Timur C, Ayhan Y, Kes G. Leukoerythroblastosis Mimicking Leukemia: A case report. Iran J Pediatr. 2014 Jun;24(3):332–3.
7. Ken Sang Lee et al. Clinical significance of Leucoerythroblastosis. Korean Journal of Internal Medicine. 1982; 25(7):694-697.
8. Burkett LL, Cox ML, Fields ML. Leukoerythroblastosis in the adult. American Journal of Clinical Pathology. 1965; 44(5):494–498.
9. Delsol G, Guiu-Godfrin B et al. Leukoerythroblastosis and cancer frequency, prognosis, and physio pathologic significance. Cancer. 1979; 44:1009–1013.
Published
2019-02-26
Section
Original Article