{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:49:11Z","timestamp":1793159351185,"version":"4.5.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82401838"],"award-info":[{"award-number":["82401838"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005230","name":"Natural Science Foundation of Chongqing Municipality","doi-asserted-by":"publisher","award":["CSTB2023NSCQ-BHX0042"],"award-info":[{"award-number":["CSTB2023NSCQ-BHX0042"]}],"id":[{"id":"10.13039\/501100005230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ital J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extreme leukocytosis in pertussis is a rare condition, and without effective interventions to reduce white blood cell counts, the mortality rate can approach 100%. The clinical characteristics of these patients and the application of exchange transfusion (ET) in their management are not yet clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study examines the clinical characteristics and impact of ET in infant pertussis with extreme leukocytosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We have included six infant pertussis patients with extreme leukocytosis, all of whom were female and underwent ET. Two patients survived, while four died. The surviving patients were relatively older at disease onset compared to those who died, and all three unvaccinated patients died. All patients required admission to the pediatric intensive care unit, presenting with fever, whooping cough, cyanosis, severe pneumonia, and respiratory failure. Pulmonary consolidation, cardiovascular failure, and pulmonary hypertension (PH) were also common, especially among those who died. Hypoglycemia and seizures were rare. Acute-phase proteins, such as C-reactive protein and procalcitonin, were elevated to varying degrees. ET effectively reduced peripheral blood leukocytes; however, a significant increase in leukocytes was observed 1\u20132 days after the first ET in the deceased patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extreme hyperleukocytosis is more commonly observed in young female children with pertussis. Younger age, unvaccinated status, and the presence of concurrent heart failure and PH may be associated with a poor prognosis. ET can effectively reduce peripheral blood leukocytes, but a rapid leukocyte rebound post-ET may be indicative of impending death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13052-025-01933-9","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T16:07:08Z","timestamp":1742314028000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical characteristics and impact of exchange transfusion in infant pertussis with extreme leukocytosis"],"prefix":"10.1186","volume":"51","author":[{"given":"Yuanyuan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-1782","authenticated-orcid":false,"given":"Chuan","family":"Gan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"issue":"2","key":"1933_CR1","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1128\/CMR.18.2.326-382.2005","volume":"18","author":"S Mattoo","year":"2005","unstructured":"Mattoo S, Cherry JD. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev. 2005;18(2):326\u201382.","journal-title":"Clin Microbiol Rev"},{"key":"1933_CR2","doi-asserted-by":"publisher","unstructured":"Kazantzi MS, Prezerakou A, Kalamitsou SN et al. Characteristics of Bordetella pertussis infection among infantsand children admitted to paediatric in tensive care units in Greece: a multicentre, 11-year study. J Paediatr Child Health. 2017;53(3):257\u2013262. https:\/\/doi.org\/10.1111\/jpc.13427","DOI":"10.1111\/jpc.13427"},{"key":"1933_CR3","doi-asserted-by":"publisher","unstructured":"Burr JS, Jenkins TL, Harrison R, The Collaborative Pediatric Critical Care Research Network Critical Pertussis Study: collaborative research in pediatric critical care medicine. 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As the study did not involve additional interventions or experimental operations, the ethics committee approved the waiver of informed consent. The study was approved by the Ethics Committee of the Children\u2019s Hospital of Chongqing Medical University and complies with the ethical standards of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approvals and consent to participate"}},{"value":"Written informed consent was obtained from the guardian for the publication of any potentially identifiable images or data included in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"82"}}