Fever without a source: evolution of a diagnosis from Kawasaki disease to acute myelogenous leukaemia
Autor: | Begem Lee, Christine D Kofman, Dennis John Kuo, Adriana H. Tremoulet |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Abdominal pain Fever Anemia medicine.medical_treatment Aftercare Hematopoietic stem cell transplantation 030204 cardiovascular system & hematology Mucocutaneous Lymph Node Syndrome Irritability 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Medicine Humans medicine.diagnostic_test business.industry Hematopoietic Stem Cell Transplantation Immunoglobulins Intravenous Infant Bone Marrow Examination General Medicine medicine.disease Reminder of Important Clinical Lesson Coronary arteries Bone marrow examination Leukemia Myeloid Acute medicine.anatomical_structure Treatment Outcome Echocardiography 030220 oncology & carcinogenesis Kawasaki disease medicine.symptom business Erythrocyte Transfusion |
Popis: | A previously healthy 11-month-old male patient presented with fever, abdominal pain and irritability. As part of an extensive evaluation for the cause of his fevers, an echocardiogram was performed and showed mildly dilated coronary arteries, leading to a diagnosis of incomplete Kawasaki disease (KD). He was treated with intravenous immunoglobulin (IVIG), defervesced and was discharged home. Two weeks later, he presented with anaemia initially attributed to haemolytic anaemia secondary to IVIG and received a red blood cell transfusion. However, his anaemia recurred 2 weeks later with leucocytosis, prompting a bone marrow aspirate 4 weeks after his diagnosis of KD. This demonstrated acute myelogenous leukaemia most consistent with acute megakaryocytic leukaemia. This case highlights the potentially subtle presentation of acute leukaemia and the need to keep an open mind and reconsider the initial diagnosis as new information comes to light in the care of an ill child. |
Databáze: | OpenAIRE |
Externí odkaz: |