Congenital leukemia is a very rare malignancy of childhood with poor prognosis. The incidence is nearly 1 in 5 million live births. Although mortality is high due to aggressive course and complications of the treatment, the two-year survival rate is 23% [2]. The etiology is unknown but it is assumed that genetic factors, environmental factors, viral infections and immune deficiencies may be responsible. Among many clinical symptoms and signs hepatosplenomegaly, petechia, eccyhmoses and nodular skin lesions may present since birth. Against childhood, in neonatal period two thirds of the leukemia are originated from myeloid cells. The most defined types are AML M4 and M5. We report a 23 days old girl who was diagnosed as AML M1 with a rare complication of pericardial effusion.
Case Report
Peripheral blood smear revealed atypical cells so he was referred to our hospital with pre-diagnosis of congenital leukemia. At admission she was 23-days-old, 3460 grams in weight, 50.5 cm in height, 35 cm in head circumference. Her physical examination revealed phenotypically normal girl with pallor, periorbital hyperemia and edema, ecchymotic lesions and edema on bilateral hands and feet, nearly 2 cm diameters mobile and solid nodules over the trunk and anterior surfaces of the thighs. Liver was 4 cm and spleen was 3 cm palpable below costal margin and 2/6 systolic murmur was heard. Laboratory evaluations were as following: leucocyte count 40410/mm3, hemoglobin 9.2 gr/dl, hematocrit 27.4%, platelet count 175000/mm3, LDH 2281 U/L, GGT 290 U/L. On peripheral blood smear there were 20% blasts.
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