急性淋巴细胞白血病呈现为慢性复发多焦点骨髓炎
Devina Singh1, Arpita Bhriguvanshi2, Chandra Kanta Kumar2
1Paediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India singhdevina12@gmail.com.
BMJ case reports
|April 7, 2025
概括
一名最初被诊断患有慢性复发性多焦点骨髓炎的儿童后来被发现患有急性淋巴细胞白血病. 这一案例强调了在患有肌肉骨症状的儿童中诊断白血病时需要保持警.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 儿科血液瘤学
背景情况:
- 肌肉骨症状如发烧和关节胀在儿童中很常见.
- 这些症状的差异诊断可以包括炎症状况和感染.
- 急性淋巴细胞白血病 (ALL) 有时会出现模仿其他疾病的非特异性症状.
研究的目的:
- 报告一种罕见的急性淋巴细胞白血病病例,其初始症状暗示慢性复发性多焦点骨髓炎.
- 强调在儿童肌肉骨疾病的差异诊断中考虑血液恶性瘤的重要性.
- 突出早期白血病检测的挑战,当症状与其他儿科疾病重叠时.
主要方法:
- 一个学前儿童长期发烧和关节胀的案例报告.
- 最初的调查包括骨髓活检和排除恶性瘤.
- 诊断从疑似骨质炎/青少年异常性关节炎演变为慢性复发性多焦点骨质炎,最后是急性淋巴细胞白血病.
主要成果:
- 这名儿童最初出现了模仿慢性复发多焦点骨髓炎的症状.
- 尽管对疑似骨髓炎进行了抗炎治疗,但该儿童患上了胰岛素减肥和肝缩症.
- 随后的骨髓活检证实了急性淋巴细胞白血病.
结论:
- 患有持续肌肉骨症状的儿童需要高度的怀疑指数,以怀疑潜在的血液恶性瘤.
- 急性淋巴细胞白血病的早期和准确的诊断对于及时干预和改善患者结果至关重要.
- 这一案例强调了诊断方面的挑战,以及在儿科血液瘤学和风湿学中需要采取警的方法.
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