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[Arthritis: an unusual and anticipatory clinical presentation of pediatric acute lymphoblastic leukemia. A case
Carolina Duarte-Salazar1, Concepción Guadalupe Santillán-Chapa, Garly Daniel González-Rosado
1Servicio de Reumatología Pediátrica, Instituto Nacional de Rehabilitación. Secretaría de Salud. México, D.F., Mexico.
Background:
Acute lymphoblastic leukemia initially shows osteoarticular manifestations. However, it is rare that it shows juvenile idiopathic arthritis (JIA) symptoms.
Clinical Case:
A child with acute lymphoblastic leukemia initially misdiagnosed with malignant neoplasia and septic arthritis, and later on with juvenile idiopathic arthritis. The child had persistent articular pain and swelling despite treatment. Six months later, a full blood count revealed leukopenia and neutropenia with lymphocytosis. A bone marrow aspirate confirmed pre-B acute lymphoblastic leukemia with hypodyploidia.
Conclusion:
This case initially showed typical signs of arthritis, and a diagnosis of acute lymphoblastic leukemia was ruled out, since the those clinical features and hematologic alterations characterizing this hematologic neoplasia.
