Osteolytic bone lesions, severe hypercalcemia without circulating blasts: unusual presentation of childhood acute lymphoblastic leukemia
| Autor: | Ben Sayed Nesrine, Regaieg Haifa, Khelif Abdrrahim, Ben Abdelkader Atef, Ben Youssef Yosra, Bouslema Emna, Achour Asma, Achour Bechir |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Biopsy Antineoplastic Agents Case Report Osteolysis Acute lymphoblastic leukemia Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Fatal Outcome medicine Humans Childhood Acute Lymphoblastic Leukemia childhood Acute leukemia Chemotherapy medicine.diagnostic_test business.industry hypercalcemia General Medicine Precursor Cell Lymphoblastic Leukemia-Lymphoma osteolytic bone lesions Surgery medicine.anatomical_structure Cervical lymph nodes 030220 oncology & carcinogenesis Child Preschool Vomiting Bone marrow Differential diagnosis medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | The Pan African Medical Journal |
| ISSN: | 1937-8688 |
| Popis: | Hypercalcemia and severe osteolytic lesions are rare complications of acute lymphoblastic leukemia (ALL) in childhood. We report a case of a 3 years old boy who presented with prolonged fever, nausea, vomiting and increasing lower limbs pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Her physical examination showed multiple cervical lymph nodes. In laboratory tests, he had severe hypercalcemia. Parathyroid hormone (PTH) was not elevated. Despite the absence of circulating blasts, bone marrow biopsy revealed B-precursor (ALL). Hypercalcemia was initially treated with intravenous isotonic sodium chloride solution and diuretics but the serum calcium level normalized only after the beginning of corticosteroids and chemotherapy. The child responded initially to chemotherapy and eventually relapsed and died of septic shock. Acute leukemia must be considered in differential diagnosis in patients with hypercalcemia. A detailed examination even when there no circulating blasts in their peripheral blood smear, and if in doubt bone marrow aspiration should must be taken into consideration. |
| Databáze: | OpenAIRE |
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