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Ectopic CS or adrenal cancer patients were excluded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main outcome measure<\/jats:title>\n            <jats:p>Mean WBC, neutrophils, and neutrophil-to-lymphocyte ratio (NLR) two-years before and after pituitary or adrenal surgery. WBC and neutrophils are expressed as Kcells\/\u00b5l.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At baseline, leukocytosis was observed in 21.5% of patients with CS vs. 8.9% of controls (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Patients with CS had significantly higher WBC (8.8\u2009\u00b1\u20092.88 vs. 7.54\u2009\u00b1\u20092.45, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), neutrophils (5.82\u2009\u00b1\u20092.38 vs. 4.48\u2009\u00b1\u20091.97, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and NLR (3.37\u2009\u00b1\u20092.63 vs. 2.27\u2009\u00b1\u20091.86, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) compared to controls, regardless of pituitary or adrenal source of hypercortisolemia. Post-surgery, patients with CS experienced significant decreases in mean WBC (-0.57\u2009\u00b1\u20092.56, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), neutrophils (-0.84\u2009\u00b1\u20092.55, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and NLR (-0.63\u2009\u00b1\u20092.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Despite achieving disease remission, patients with CS still had higher WBC (8.11\u2009\u00b1\u20092.4 vs. 7.46\u2009\u00b1\u20092.17, <jats:italic>p<\/jats:italic>\u2009=\u20090.0004) and neutrophils (4.71\u2009\u00b1\u20092.10 vs. 4.41\u2009\u00b1\u20091.87, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) compared to controls. Patients with CD and baseline leukocytosis had lower remission rate than those with normal WBC (36.7% vs. 63.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>At diagnosis, CS patients have elevated WBC, neutrophils, and NLR compared to controls. Remission does not normalize WBC levels in all patients, and baseline leukocytosis predicts a poorer remission prognosis in CD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40618-025-02535-2","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T05:36:01Z","timestamp":1738042561000},"page":"1217-1224","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Leukocytosis in Cushing\u2019s syndrome persists post-surgical remission and could predict a lower remission prognosis in patients with Cushing\u2019s disease"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0889-8025","authenticated-orcid":false,"given":"Hiba","family":"Masri-Iraqi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-6321","authenticated-orcid":false,"given":"Yaron","family":"Rudman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7576-8327","authenticated-orcid":false,"given":"Tzipora","family":"Shochat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-5249","authenticated-orcid":false,"given":"Shiri","family":"Kushnir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9188-3894","authenticated-orcid":false,"given":"Ilan","family":"Shimon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9284-6289","authenticated-orcid":false,"given":"Maria","family":"Fleseriu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9376-344X","authenticated-orcid":false,"given":"Amit","family":"Akirov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"issue":"10418","key":"2535_CR1","doi-asserted-by":"publisher","first-page":"2237","DOI":"10.1016\/S0140-6736(23)01961-X","volume":"402","author":"M Gadelha","year":"2023","unstructured":"Gadelha M, Gatto F, Wildemberg LE, Fleseriu M (2023) Cushing\u2019s syndrome. 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