title: Leukemoid Reaction in a Pediatric Patient With Diabetic Ketoacidosis.
abstract: Herein, we report a case of a 12-year-old girl who presented with diabetic ketoacidosis and a leukemoid reaction. Although this association has been described in a few adult patients, pediatric cases have not been reported. A leukemoid reaction is commonly defined as an elevation in the white blood cell count greater than 50,000/μL in response to severe illness or stress other than hematologic malignancy; it is considered to be mediated by various hormones, cytokines, and factors that are released in response to inciting triggers, such as acidosis. As highlighted in our report, distinguishing a benign leukemoid reaction from a hematologic malignancy and even tumor lysis syndrome, particularly in a setting of diabetic ketoacidosis, is crucial to ensuring safe and efficacious therapeutic interventions.
authors.affiliation: From the *Division of Pediatric Emergency Medicine, Department of Emergency Medicine, and †Division of Pediatric Endocrinology, Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Gonzalez
authors.forename: Sonali
authors.initials: S
authors.lastname: Malhotra
authors.forename: Marla
authors.initials: M
authors.lastname: Levine
authors.forename: Elka
authors.initials: E
authors.lastname: Jacobson-Dickman
mesh_terms: D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D042381:Granulocyte Precursor Cells / Q000473:pathology; D006801:Humans; D007955:Leukemoid Reaction / Q000097:blood / Q000209:etiology* / Q000628:therapy; D007958:Leukocyte Count; D009504:Neutrophils / Q000473:pathology