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Extensive calcinosis cutis in relapsed acute lymphoblastic leukaemia
Annals of the Academy of Medicine, Singapore
|March 11, 2004
Summary
This case study highlights a rare instance of calcinosis cutis and hypercalcaemia during acute lymphoblastic leukaemia (ALL) relapse. Treatment for skin calcification was ineffective, emphasizing the need to manage the underlying leukemia.
Area of Science:
- Oncology
- Dermatology
- Nephrology
Background:
- Acute lymphoblastic leukemia (ALL) relapse can present with rare complications.
- Hypercalcaemia and calcinosis cutis are unusual manifestations during ALL relapse.
Observation:
- A 19-year-old female with B precursor ALL developed extensive, painful skin plaques upon leukemia relapse.
- Clinical presentation included hypercalcaemia, hyperphosphataemia, hyperuricaemia, and acute kidney injury.
- Skin biopsy confirmed calcinosis cutis without evidence of metastatic calcification.
Findings:
- Hypercalcaemia management with hydration and pamidronate provided only partial pain relief.
- Cutaneous lesions were refractory to initial calcium-lowering treatments.
- The patient's leukemia ultimately proved fatal four months post-presentation.
Implications:
- Calcinosis cutis treatment in this context was unsatisfactory.
- Effective management of calcinosis cutis is contingent upon successful treatment of the underlying leukemia.
- This case underscores the complex and challenging manifestations of relapsed ALL.