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An unusual presentation of pediatric acute lymphoblastic leukemia with parotid gland involvement and dactylitis

Şule Ünal1, Barış Kuşkonmaz, Yasemin Işık Balcı

  • 1Hacettepe University, Division of Pediatric Hematology 06100 Ankara, Türkiye Phone: + 90 312 305 11 70

Turkish Journal of Haematology : Official Journal of Turkish Society of Haematology
|June 7, 2016
PubMed

Insights

Mumps infection in children with acute lymphoblastic leukemia (ALL) typically presents mildly. However, atypical presentations, like parotid swelling in a vaccinated child, warrant suspicion for ALL.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Immunology

Background:

  • Childhood acute lymphoblastic leukemia (ALL) treatment often involves immunosuppression.
  • Mumps infection typically has a mild course in ALL patients, unlike measles or varicella.

Purpose of the Study:

  • To highlight the importance of considering ALL in cases of atypical infections during childhood.
  • To present a case of mumps infection mimicking parotid involvement in a child with ALL.

Main Methods:

  • Case report of a three-year-old girl.
  • Clinical presentation, laboratory findings (serum IgM positivity for mumps), and diagnosis of ALL with persistent bilateral parotid involvement were analyzed.

Main Results:

  • The patient presented with bilateral parotid swelling and dactylitis, initially suggestive of mumps infection.
  • Despite vaccination and initial mumps seropositivity, the persistent parotid involvement was inconsistent with a typical mumps infection, leading to an ALL diagnosis.
  • Mumps infection at ALL presentation, similar to during treatment, followed a mild clinical course.

Conclusions:

  • Atypical presentations of common childhood infections should raise suspicion for underlying acute lymphoblastic leukemia.
  • Prompt diagnosis and management of ALL are crucial, even when masked by seemingly mild infections.

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