A patient has a white blood count of 35 ´ 109/L with a left shift. The leukocyte alkaline phosphatase stain is 220. Which of the following is most likely?
a. Severe bacterial infection
b. Chronic myelogenous leukemia
c. Paroxysmal nocturnal hemoglobinuria
d. Values normal
ANS: A
A normal leukocyte alkaline phosphatase score should be roughly 20 to 100; therefore this score of 220 is very elevated. An elevated leukocyte alkaline phosphatase is consistent with a severe bacterial infection. Both chronic myelogenous leukemia and paroxysmal nocturnal hemoglobinuria have below-normal scores.
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