Eosinophilic leukemoid reaction in a child with mixed helminthiasis

Abstract

Leukemoid reactions (LR) are changes in the blood and hematopoietic organs that resemble leukemias and other tumors of the hematopoietic system, but are always reactive in nature and do not transform into cancer. Viruses, toxins of tissue helminths, biologically active substances that are released during erythrocytes hemolysis, immune, allergic processes, and sepsis play an etiological role in the LR development. In such cases hematopoietic cell hyperplasia is possible with a normal ratio of elements in the bone marrow.

The aim is to familiarize doctors using a clinical case as the example with the diagnosis and treatment of mixed helminthiasis complicated by eosinophilic LR in a child.

A clinical case of the eosinophilic leukemoid reaction in a child with mixed helminthiasis: toxocarosis, trichinellosis, ascariasis is described. 8 years old boy was admitted to the infectious diseases hospital on the 13th day of illness with complaints of increased body temperature up to 39.0-39.5°C, body ache. Before admission the child was examined by a pediatrician and diagnosed with acute respiratory disease: tonsillopharyngitis. The precriptions included antibiotic therapy and non-steroidal anti-inflammatory drugs, positive dynamics was absent. Toxocarosis, trichinellosis and ascariasis were diagnosed in the infectious diseases hospital, antihelmintic and symptomatic therapy was prescribed. However, the child's condition did not improve, leukocytosis and eosinophilia increased in the blood. In order to rule out a neoplastic process, the child underwent a bone marrow puncture, and no signs characteristic of leukemia were detected. Glucocorticoids and antihistamines were prescribed, against the background of which positive clinical and laboratory dynamics were observed.

Conclusions. The presented clinical case demonstrates the need for careful analysis of clinical, anamnestic, epidemiological and objective examination data for the diagnosis of helminthiasis. In the presence of hypereosinophilia, it is important to do differential diagnose of its causes namely tumors, infectious and rheumatological diseases, allergic and atopic conditions, parasitosis. Such patients always require a multidisciplinary approach during diagnosis and treatment.

The research was carried out in accordance with the principles of the Helsinki Declaration. Informed consent of the child's parents was obtained for the research.

The authors declare no conflict of interest.