Oxygen Leukocyte Larceny

Authors

  • Miguel Pinto da Costa Serviço de Patologia Clínica. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia.
  • Henrique Pimenta Coelho Serviço de Hematologia Clínica. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia.

DOI:

https://doi.org/10.20344/amp.6874

Keywords:

Anoxia, Leukocytosis, Oxygen Consumption, Oximetry.

Abstract

The authors present a case of a 60-year-old male patient, previously diagnosed with B-cell chronic lymphocytic leukemia, who was admitted to the Emergency Room with dyspnea. The initial evaluation revealed severe anemia (Hgb = 5.0 g/dL) with hyperleukocytosis (800.000/µL), nearly all of the cells being mature lymphocytes, a normal chest X-ray and a low arterial oxygen saturation (89%; pulse oximetry). After red blood cell transfusion, Hgb values rose (9.0 g/dL) and there was a complete reversion of the dyspnea. Yet, subsequent arterial blood gas analysis, without the administration of supplemental oxygen, systematically revealed very low oxygen saturation values (~ 46%), which was inconsistent with the patient’s clinical state and his pulse oximetry values (~ 87%), and these values were not corrected by the administration of oxygen via non-rebreather mask. The investigation performed allowed to establish the diagnosis of oxygen leukocyte larceny, a phenomenon which conceals the true oxygen saturation due to peripheral consumption by leukocytes.

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Author Biographies

Miguel Pinto da Costa, Serviço de Patologia Clínica. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia.

Médico Interno de Patologia Clínica no CHVNG/E.

Mestre em Medicina pela Faculdade de Medicina da Universidade do Porto.

Henrique Pimenta Coelho, Serviço de Hematologia Clínica. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia.

Assistente Hospitalar e Director de Serviço de Hematologia Clínica do CHVNG/E.

Mestre em Imunologia pela Universidade de Oxford.

Licenciado em Medicina pela Faculdade de Medicina da Universidade do Porto.

Published

2016-05-31

How to Cite

1.
Pinto da Costa M, Pimenta Coelho H. Oxygen Leukocyte Larceny. Acta Med Port [Internet]. 2016 May 31 [cited 2024 Nov. 21];29(5):343-7. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/6874

Issue

Section

Case Report