title: Acute pyelonephritis with anaplastic thyroid carcinoma producing granulocyte colony-stimulating factor.
abstract: Paraneoplastic leukocytosis was defined as elevated white blood cell (WBC) levels caused by cytokines, likely produced by the tumor itself, without evidence of infection or myeloproliferative disease. We report a case of anaplastic thyroid carcinoma with leukocytosis caused by elevated production of granulocyte colony-stimulating factor (G-CSF) by the carcinoma. Initially, acute pyelonephritis (APN) was diagnosed and treatment for APN was ongoing, but the WBC count steadily increased to 68.8×10(9)/L. She was diagnosed with anaplastic thyroid carcinoma on her neck mass, and the serum concentration of G-CSF was found to be markedly increased at 1,010 pg/mL. In spite of supportive care, the patient's condition rapidly deteriorated and the patient died on day 23 of hospital stay. Leukocytosis without definite evidence of infection could be a paraneoplastic manifestation in patients with malignant tumors, and paraneoplastic leukocytosis may be related to poor prognosis.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Keunhee
authors.initials: K
authors.lastname: Kang
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Park
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Ryu
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lee
authors.forename: Gang Jee
authors.initials: GJ
authors.lastname: Ko
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Kwon
keywords: Anaplastic thyroid carcinoma; G-CSF; Paraneoplastic leukocytosis