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ORIGINAL ARTICLE
Year : 2020  |  Volume : 11  |  Issue : 3  |  Page : 116-121

Impact of single-dose systemic glucocorticoids on blood leukocytes in hospitalized adults


1 Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
2 Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA

Correspondence Address:
Dr. Khalid Eljaaly
Department of Pharmacy Practice, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_24_20

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BACKGROUND: Glucocorticoids (GCs) may cause leukocytosis through several mechanisms. The objective of this study was to examine the impact of a single-GCs dose on total white blood cell (WBC) count, absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) in hospitalized adults without bacterial infections. METHODS: This retrospective cohort study included hospitalized patients ≥18 years of age who received a single dose of a systemic GC (oral or intravenous methylprednisolone and hydrocortisone and oral prednisone). Total WBC count, ANC, and ALC changes over the 72 h after GC administration were evaluated. RESULTS: A total of 99 patients were included. After the administration of a single-GC dose, ALC began to drop significantly as early as the interval of 0–<6 h (median interquartile range, 0.90 [0.60–1.10], P = 0.011). ANC increased significantly as early as the interval of 6–<12 h (6.22 [4.45–7.33], P = 0.049) and continued to be significantly increased from baseline up to 42 h from GC administration. Total WBC counts significantly decreased in the 6–<12 h interval (6.90 [5.15–8.85], P = 0.03) and then increased significantly in the 12–<18 h interval (8.80 [6.50–11.95], P = 0.002). This effect on total WBC count continued to be significant until the 36-<42 h interval (10.55 [7.23–13.03], P < 0.001). CONCLUSIONS: ANC followed by WBC count increased significantly after a single-GC dose in hospitalized patients within 12 h of a single-GC dose, while a decrease in WBC and ALC was seen within the first few hours of GC dose.


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