Leukemoid like reaction in a post CABG patient

Area of Science:

• Cardiology
• Hematology
• Critical Care Medicine

Background:

• Leukemoid reactions, characterized by elevated white blood cell counts, are uncommon following cardiac surgery.
• Distinguishing leukemoid reactions from infection is crucial in post-operative management.
• Limited literature exists on leukemoid reactions specifically after coronary artery bypass graft (CABG) surgery.

Purpose of the Study:

• To report a rare case of a leukemoid-like reaction in a patient after CABG surgery.
• To investigate the correlation between extra-corporeal circulation and the exaggerated inflammatory response.
• To differentiate this reaction from a true leukemoid reaction and infection.

Main Methods:

• Case report of a patient undergoing CABG surgery.
• Monitoring of leukocyte count and inflammatory markers.
• Assessment for signs of infection.
• Analysis of the patient's inflammatory response in relation to extra-corporeal circulation duration.

Main Results:

• The patient exhibited a significantly elevated leukocyte count post-CABG surgery.
• No evidence of infection was detected.
• The inflammatory response was pronounced but did not meet the strict definition of a leukemoid reaction, termed 'leukemoid-like reaction'.
• A direct correlation was observed between the duration of extra-corporeal circulation and the magnitude of the inflammatory response.

Conclusions:

• A leukemoid-like reaction can occur post-cardiac surgery, particularly after CABG.
• Extra-corporeal circulation appears to be a significant factor contributing to this exaggerated inflammatory response.
• This case underscores the importance of considering non-infectious causes for elevated leukocyte counts in the post-cardiac surgery setting.