- 期刊
Transient Leukemoid Reaction in an Extremely Premature Neonate
一極低出生體重新生兒之一過性類白血病反應
摘要
類白血病反應在新生兒期的主要成因有敗血症，嚴重溶血，唐氏症，及少數染色體異常症。我們報告一懷孕26週出生僅l,000公克之早産女嬰，其出生當天的白血球數爲68,900/mm^3，理學檢查無肝脾大，或是出血點的問題。其白血球數在第五天大時上異至207,000/mm^3，分類中可見到38%的白血球爲promyelocyte,myelocyte,及metamyelocyte。至於血小板最低時是在第八天大時的86,000/mm^3，骨髓細胞染色體檢查正常。雖然在第五天大時的血液培著有葡萄球菌的生長，但細菌是培養七天後才有少許菌落生出因此被判斷爲污染性培養結果。母親於生産前曾接受一劑的dexamethasone注射，被認爲可能是導致此早産兒發生類白血病反應的原因之一。
關鍵字
無資料並列摘要
A female newborn was delivered prematurely at gestational age of 26 weeks with birth weight of 1,000 grams. Her initial white blood cell count was 68,900/mm3, which increased to 207,000/mm3 on the fifth day of life with a remarkable shft-to-lefi pattern. The most immature myeloid series in the peripheral blood smear was promyelocyte; and the promyelocyte, myelocyte and metamyelocyte accounted for 38% of the peripheral white blood cells. Neither hepatosplenomegaly nor skin rash was noted, but the platelet count dropped to 86,000/mm3 transiently on Day 8. Cytogenetic study for the bone marrow aspiration revealed normal results. The leukemoid reaction recovered within three weeks without specific treatment. Antenatal usage of steroid to promote lung maturation was considered to be one possible cause of the transient leukemoid reaction.