LEUKEMOID REACTION AS A CONSEQUENCE OF EPSTEIN-BARR VIRUS INFECTION
DOI:
https://doi.org/10.46793/PP250131017SKeywords:
Leukemoid reaction, Epstein-Barr virus, Infectious mononucleosisAbstract
Introduction: A leukemoid reaction is defined as an increase in white blood cell count exceeding 30,000/µL, with a predominance of immature cells, commonly seen in infectious and malignant conditions. Epstein-Barr virus (EBV) is known for its cytopathogenic effect on B lymphocytes and is the causative agent of infectious mononucleosis. It has also been associated with the development of Hodgkin's lymphoma, non-Hodgkin lymphoma, and nasopharyngeal carcinoma. Although it is rare, EBV infection can cause a significant elevation in white blood cells, necessitating comprehensive diagnostic workup to differentiate infectious mononucleosis from leukemia.
Case Presentation: This report describes a case of a 3-year-old girl presenting with a 3-day history of fever (38.5°C) followed by laboratory findings of leukocytosis (53,000/µL), with a predominance of lymphocytes and monocytes. On physical examination, bilateral cervical lymphadenopathy up to 1 cm in diameter was noted. No other abnormal findings were observed on systemic examination. In the hospital, peripheral blood smear, bone marrow aspiration, and EBV serology were performed, leading to the diagnosis of infectious mononucleosis.
Conclusion: While a markedly elevated white blood cell count due to EBV infection is rare, leukemia must always be ruled out, especially in the absence of significant physical findings.
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