A 6-year-old girl with polycystic kidney disease is started on a new medication after receiving a kidney transplant from a matched, unrelated donor. Two days after starting the medication, laboratory studies show a leukocyte count of 17,500/mm3 (90% segmented neutrophils, 4% bands, 1% eosinophils, 3% lymphocytes, and 1% monocytes). Which of the following drugs is the most likely cause of these laboratory findings?

Question

Quizplus · Accepted Answer

Eductional Objective: The presence of neutrophilia without left shift (no increase in bands) is classic for glucocorticoid-induced leukocytosis. Glucocorticoids inhibit the attachment of neutrophils to their endothelial surface receptors, resulting in demargination. Other minor mechanisms of glucocorticoid-induced leukocytosis include delayed apoptosis and a slight increase in bone marrow production, which typically occur 24 hours after administration.

A 6-Year-Old Girl with Polycystic Kidney Disease Is Started on a New