Introduction
A reactive leukocytosis, with a significant increase in early neutrophil
precursors, exceeding 50,000/mm3 is referred to as a leukemoid
reaction[1]. The major causes of a leukemoid reaction include
paraneoplastic manifestation of several cancers such as lung,
gastrointestinal, genitourinary, ovarian, head and neck cancers and
hepatocellular carcinoma[2,3], severe infections, intoxications,
corticosteroid administration, severe haemorrhage and acute
haemolysis[4,5]. The differential diagnosis of a leukemoid reaction
in patients is often a true challenge. Diagnostic work-up must be able
to differentiate underlying causes from acute and chronic
leukaemia[6]. These reactions have been attributed to increased
cytokine production[7]. The cytokines implicated in this process
include granulocyte-macrophage colony-stimulating factor (CSF),
granulocyte-CSF (G-CSF), interleukin-3 (IL-3) and IL-6[8,9]. Most
leukemoid reactions are seen in senior patients and are associated with
a poor prognosis[10]. Here, the case of a young woman who had severe
clinical symptoms, a leukemoid reaction after major surgery, and who
progressed to a good outcome in the end, is presented.