scholarly journals Leukemoid Reaction in a Case of Chronic Cholecystitis With Focal Mild Acute Inflammation

2021 ◽  
Vol 44 (3) ◽  
pp. 51-56
Author(s):  
Likhasit Sanglutong ◽  
Somchai Insiripong ◽  
Taweechai Wisanuyothin

Leukemoid reaction is a rare condition of marked increase of the white blood cells (WBC) in the peripheral blood, mostly more than 50 × 109/L. Although its most common cause is infection, acute or chronic cholecystitis has been hardly mentioned. This report aimed to present the leukemoid reaction found in a Thai who had chronic cholecystitis with focal acute inflammation. A 74-year-old woman had low-graded fever and generalized vague abdominal discomfort for 2 days. The physical examination showed the body temperature 37.7 °C and unremarkable abdominal signs. Her blood tests showed: hemoglobin 9.0 g/L, WBC 52.48 × 109/L, neutrophil 91%, band form 1%, platelet 434 × 109/L, and alkaline phosphatase (ALP) 290 U/L. The blood cultures yielded no growth. The computed tomography of the abdomen revealed 2 stones in the common bile duct (CBD) causing obstruction; the gall bladder (GB) showed mild dilatation with thin wall containing multiple small gall stones; no pericholecystic fluid and normal size of spleen. She promptly underwent operative cholecystectomy, CBD choledochoscopy, stones removal and T-tube choledochostomy. Along with the surgery, intravenous ertapenem was also administered. The pathology of the gall bladder was chronic cholecystitis with focal mild acute inflammation. With these therapies, fever daily decreased and finally disappeared within 5 days meanwhile the WBC count also gradually diminished every day till 8.04 × 109/L within 7 days. The WBC count was still normal one month later. The diagnosis of leukemoid reaction was concluded and it was presumably be associated with chronic calculous cholecystitis with focal acute inflammation although the BCR-ABL translocation had never been explored.  

2021 ◽  
Author(s):  
K. Rahimunnisa ◽  
V. Aparna ◽  
R.K. Harrini ◽  
K. Kamalini

RBC (Red Blood Cells) and WBC (White Blood Cells) are the main constituents of blood. WBC fight infections by attacking bacteria and viruses, that invade the body, while RBC transports oxygen in the body. Many blood diseases can be detected using RBC and WBC count values. Immunity-related blood diseases like Leukopenia and Leukocytosis can be easily detected using the WBC count value. The manual counting method of blood cells in laboratories takes at least one day to get the blood results, which becomes a major drawback for healthcare sectors to diagnose the disease at the right time. More expensive pathological tests are also a major drawback. Accurate counting of blood cells is essential in the accurate diagnosis of the disease. The proposed system is used to calculate the RBC and WBC Count, Total blood Count, RBC and percentage and the blood disease (Leukocytosis, Leukopenia) from the input blood smear image. This will help laboratories to perform the counting of blood cells with high accuracy and less workload. This is achieved by pre-processing that involves grayscale conversion, image enhancement, noise removal, binary conversion of input image, followed by plane extraction and threshold-based Segmentation. The blood disease (Leukocytosis and Leukopenia) is detected using WBC percentage-based classification methodology. This approach obtained an accuracy of 98.4%, specificity of 88.889%, precision of 99.58%, F - Measure of 99.50%. Morphological operations are implemented using MATLAB software.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1705-1705
Author(s):  
Pauline D Balkaransingh ◽  
David Wheeler ◽  
Yi Ning ◽  
Marieka A. Helou ◽  
Gita Massey

Abstract Introduction White blood cells are key components of the immune system. They defend the body against a host of diseases and infections. Various studies have explored the possible influence of dietary nutrients on the white blood cell (WBC) count. If it can be demonstrated that nutrients affect the WBC count, they may offer an inexpensive way of modulating the immune system and in turn, the body's ability to fight against disease and infection. The sample sizes of previous studies, however, have been relatively small. The results have therefore been variable and conflicting. The purpose of this study is to continue to explore the dietary determinants of the WBC count, using a database that allows for a larger sample size, the 2005-2006 National Health and Nutrition Health Survey (NHANES). Methods The main outcome variable, WBC count, was recoded to the normal range for ages ≥ 18 years, of 4-11(±2). This was done in order to account for extreme values; particularly high and low values secondary to disease or infection. The population means and 95% confidence intervals were obtained using the statistical weights for the key variables of interest (Table 1). Multiple linear regression and backward elimination were used to predict the final model (Table 2). Variables with p < 0.1 were kept in the model. SAS 9.3 was used for all statistical analyses. Results Associations for age, gender, race and Body Mass Index (BMI) and WBC count, were consistent with previous studies and were all statistically significant (p< 0.0001). It has been shown that more intense physical activity usually leads to an increase in the WBC count. In this study, however, more vigorous forms of activity were associated with a lower WBC count (p < 0.0001). Increases in dietary copper and iron were associated with a subsequent decrease in the WBC count (Table 2, p < 0.05). An increase in vitamin K was also associated with a decrease in WBC count, however, it was not statistically significant (Table 2, p > 0.05). Increases in vitamin B1 were associated with an increase in WBC count (p < 0.05). Conclusion The results of this study suggest that further prospective studies are needed to investigate the role of these nutrients as determinants of the WBC count. Disclosures: No relevant conflicts of interest to declare.


Author(s):  
Aparna M. Kulkarni ◽  
Esha Devendra Jadhav ◽  
Ravindra V. Ramteke

Background: Gall bladder diseases are a very common health problem that affects millions of people throughout the world. Cholelithiasis is commonly associated with carcinoma gallbladder. Cholecystectomy is the most commonly performed surgical procedure done for gall bladder disease.Methods: A total of 161 cases of gall bladder lesions were evaluated from January 2017 to December 2018 which were sent to department of pathology. Specimens were fixed in 10% formalin. Appropriate areas were selected from the specimen and grossed, processed, sectioned, stained using haematoxylin and eosin and were observed under microscope.Results: Out of 161 cases, 105 were female (65.22%) and 56 cases were male (34.78%).Histopathologically, the most common diagnosis was Chronic calculus cholecystitis (57.76%) followed by chronic acalculus cholecystitis (22.36%). Remaining cases were of Acute on chronic cholecystitis (6.21%), Acute on chronic cholecystitis with cholelithiasis (4.96%), Acute on chronic cholecystitis with perforation peritonitis (1.24%), Acute suppurative cholecystitis with perforation peritonitis (0.62%), Biliary Atresia (1.24%), Chronic cholecystitis with choledochal cyst (1.24%), Follicular cholecystitis (1.24%), Adenocarcinoma (0.62%), Adenosquamous carcinoma (0.62%) and one case was inconclusive (0.62%).Conclusions: The incidence of chronic calculus cholecystitis was found to be 57.76% with female preponderance and mostly in third decade. Malignancy of gall bladder is a rare condition. Routine histopathological examination of all cholecystectomy specimens is strongly recommended for the detection of various variants of chronic cholecystitis and also of incidental carcinoma of gall bladder which helps in their treatment and prognosis.


Swiss Surgery ◽  
2002 ◽  
Vol 8 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Halkic ◽  
Abdelmoumene ◽  
Gintzburger ◽  
Mosimann

Acute appendicitis is the most common acute surgical infection during pregnancy. Although usually pyogenic in origin, parasitic infections account for a small percentage of cases. Despite the relatively high prevalence of acute appendicitis in our environment, it is not commonly associated with schistosomiasis. We report here the association of pregnancy and appendicitis caused by Schistosoma haematobium. Schistosomiasis is very common complication of pregnancy in hyperendemic areas. Schistosome egg masses can lodge throughout the body and cause acute inflammation of the appendix, liver and spleen. Congestion of pelvic vessels during pregnancy facilitates passage of eggs into the villi and intervillous spaces, causing an inflammatory reaction. Tourism and immigration make this disease a potential challenge for practitioners everywhere.


2020 ◽  
pp. 15-18
Author(s):  
Inna R. Kilmetova ◽  
◽  
Igor A. Rodin ◽  
Nazira I. Khayrullina ◽  
Nikolay G. Fenchenko ◽  
...  

Summary. The disbalanced feeding and the uneven distribution of micro- and macroelements in the environment leads to a trace element, in particular hypomelanosis. To accelerate the growth and preservation of young farm animals include in the diet of various biological additives and drugs, which include selenium. For stimulation of weight gain in the livestock industry, as well as for the prevention and treatment of pathological processes in addition to micro - and macrouse amino acids, primarily methionine. The aim of this work was to study the influence of composition of DAFS-25+Polizon on morpho-biochemical parameters of blood and functional state of the liver in fattening bulls of black-motley breed in the conditions of the Republic of Bashkortostan. Experiments using were conducted on bull-calves of black-motley breed of the properties in the properties age from 6 to 15 months. The first experimental group during the experiment was additionally given the composition of DAFS-25+Polizon at a dose of 2 mg/kg, the animals of the control group received a standard diet. To assess the impact of the composition DAFS-25+Polizon on metabolism cattle studied morphological and biochemical indicators of blood and conducted histological examination of the liver. It is established that the use of the composition of DAFS-25+Polizon at a dose of 2 mg/kg increases the number of erythrocytes and hemoglobin in the experimental group and reduces the amount of white blood cells. The serum content of total protein, phosphorus and calcium increases in the group of experimental animals. Microscopic examination of the liver revealed no changes in the structure of the organ and hepatocytes in the experimental group, whereas in the control group hemodynamic disorders and dystrophic changes in liver cells were observed. Thus, the use of the composition DAFS-25+Polizon at a dose of 2 mg/kg of live weight in fattening bulls black-and-white breed contributes to the increase of redox processes in the body, stimulation of metabolism, prevent the development of liver disorders of cellular mechanisms of metabolism, optimizes the structure of the liver, which generally provides higher productivity.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
V. Thadchanamoorthy ◽  
Kavinda Dayasiri ◽  
M. Thirukumar ◽  
N. Thamilvannan ◽  
S. H. Chandraratne

Abstract Background Aplasia cutis congenita is regarded as congenital focal absence of skin in the newborn, and occurrence of more than three similar skin defects is rare. The etiology is thought to be multifactorial, and precise etiopathogenesis is unknown. Case presentation A 13-day-old newborn Sri Lankan Tamil girl was referred to the dermatologic clinic with multiple skin defects at birth. There were six lesions on the body, and two of them had healed during intrauterine period, leaving scars. This was a second twin of her pregnancy. Her first twin fetus had demised before 19 weeks of pregnancy and was confirmed to be fetus papyraceous based on ultrasound-guided fetal assessment. The said child was thoroughly investigated and found to have no other congenital abnormalities. Chromosomal studies yielded normal findings. She was treated with tropical antibacterial ointment, and all lesions resolved spontaneously within 4 weeks, leaving scars. Physiotherapy was commenced to prevent contracture formation, and follow-up was arranged in collaboration with the plastic surgical team. Conclusions Aplasia cutis congenita is a rare condition of uncertain etiology, but consanguinity may play a role. This report described a newborn with type V cutis aplasia congenita in whom the diagnosis was confirmed based on clinical features and revision of antenatal history. The management depends on the pattern, extent, location, severity, underlying causes, and associated anomalies.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lovenish Bains ◽  
Haraesh Maranna ◽  
Pawan Lal ◽  
Ronal Kori ◽  
Daljit Kaur ◽  
...  

Abstract Background Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy. Case report A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0). Discussion It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature. Conclusion Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Zhu ◽  
Xiaokai Feng ◽  
Chunguo Jiang ◽  
Song Mi ◽  
Liya Yang ◽  
...  

Abstract Background Coronavirus disease-19 (COVID-19) has become a world health threaten. Its risk factors with death were still not known. White blood cells (WBC) count as a reflection of inflammation has played a vital role in COVID-19, however its level with death is not yet investigated. Methods In this retrospective, single-center study, all confirmed patients with COVID-19 at West Branch of Union Hospital from Jan 29 to Feb 28, 2020 were collected and analyzed. Demographic and clinical data including laboratory examinations were analyzed and compared between recovery and death patients. Results A total of 163 patients including 33 death cases were included in this study. Significant association was found between WBC count and death (HR = 1.14, 95%CI: 1.09–1.20, p < 0.001). The regression analysis results showed there was a significant association between WBC count and death (HR = 5.72, 95%CI: 2.21–14.82, p < 0.001) when use the second quartile as a cutoff value (> 6.16 × 10^9/L). The difference was still exist after adjusting for confounding factors (HR = 6.26, 95%CI: 1.72–22.77, p = 0.005). In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p < 0.001) in those with WBC count ≥6.16 × 10^9/L. Conclusion WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19.


2020 ◽  
pp. 000313482097978
Author(s):  
Annie Tang ◽  
Caitlin M. Cohan ◽  
Genna Beattie ◽  
Colin M. Mooney ◽  
Anna Chiang ◽  
...  

Background Subtotal cholecystectomy is a “damage control” or “bailout procedure” that is used in difficult gallbladder cases when severe inflammation distorts the local anatomy resulting in increased risk in damage to surrounding structures. Subtotal cholecystectomy rates increased nationally over the past decade. We aimed to determine provider experience and patient factors associated with the performance of subtotal cholecystectomies. Methods All cholecystectomies from 2016 to 2019 were reviewed. Patient demographics, laboratory values, imaging, preoperative diagnosis, surgical technique (fenestrating vs. reconstituting), and years of attending and resident experience were collected. Multivariable regression analysis was performed to evaluate for factors that increase the likelihood of subtotal cholecystectomy. Results Of 916 cholecystectomies, 86 were subtotal. The likelihood of subtotal cholecystectomy did not increase based on attending experience of ≤5 vs. > 5 years (odds ratio (OR) .66, P = .09). Older age (adjusted odds ratio (aOR) 1.23, P = .03), male sex (aOR 2.59, P < .01), white blood cells (WBC) above 10.3 (aOR 2.02, P = .02), and preoperative diagnosis of acute on chronic cholecystitis (aOR 5.47, P < .01) were associated with increased likelihood of subtotal cholecystectomy. Discussion Older age, male sex, WBC above 10.3, and preoperative diagnosis of acute on chronic cholecystitis were associated with the increased likelihood of subtotal cholecystectomies. The performance of subtotal cholecystectomy was not impacted by attending years of experience. In cases of severe gallbladder pathology, this technique is being used as an operative strategy among all surgeon levels.


Cells ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 1443
Author(s):  
Marina G. Yefimova ◽  
Celia Ravel ◽  
Antoine D. Rolland ◽  
Nicolas Bourmeyster ◽  
Bernard Jégou

Timely and efficient elimination of apoptotic substrates, continuously produced during one’s lifespan, is a vital need for all tissues of the body. This task is achieved by cells endowed with phagocytic activity. In blood-separated tissues such as the retina, the testis and the ovaries, the resident cells of epithelial origin as retinal pigmented epithelial cells (RPE), testis Sertoli cells and ovarian granulosa cells (GC) provide phagocytic cleaning of apoptotic cells and cell membranes. Disruption of this process leads to functional ablation as blindness in the retina and compromised fertility in males and females. To ensure the efficient elimination of apoptotic substrates, RPE, Sertoli cells and GC combine various mechanisms allowing maintenance of tissue homeostasis and avoiding acute inflammation, tissue disorganization and functional ablation. In tight cooperation with other phagocytosis receptors, MERTK—a member of the TAM family of receptor tyrosine kinases (RTK)—plays a pivotal role in apoptotic substrate cleaning from the retina, the testis and the ovaries through unconventional autophagy-assisted phagocytosis process LAP (LC3-associated phagocytosis). In this review, we focus on the interplay between TAM RTKs, autophagy-related proteins, LAP, and Toll-like receptors (TLR), as well as the regulatory mechanisms allowing these components to sustain tissue homeostasis and prevent functional ablation of the retina, the testis and the ovaries.


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