Hyperleukocytosis is a medical emergency requiring
prompt identification with immediate leukocyte reduction
utilizing leukapheresis, hydroxyurea, and induction chemotherapy.
Newer chemotherapy and leukapheresis techniques
are being developed in many cancer centers. However,
because of the multi-organ involvement and
aggressive nature of hyperleukocytosis, therapy must focus
on early identification and rapid intervention to minimize
mortality.
or thrombocytosis.,
due to the intravenous iodine contrast. We report the case
of a patient with hyperleukocytosis secondary to myelofibrosis
who presented with altered mental status and pseudo-hypoxemia.
We discuss the differential diagnoses of
hypoxemia in this setting and the role of point-of-care
arterial blood gas (ABG) analysis in diagnosing pseudohypoxemia.