Pediatric Acute Promyelocytic Leukemia Presenting to the Emergency Department as Refusal to Ambulate

A previously healthy 10-year-old girl presented to the emergency department (ED) with a headache and vomiting which resolved with oral NSAIDs. The patient returned two days later unable to ambulate with mental slowing and lower extremity bruising. Labs demonstrated marked leukocytosis, severe anemia...

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Bibliographic Details
Published in:Case reports in emergency medicine 2018, Vol.2018 (2018), p.1-4
Main Authors: Schwartz, Kevin R., Friedmann, Alison M., Hanson, Jennifer M.
Format: Article
Language:English
Subjects:
Acids
Arsenic
Blood platelets
Blood pressure
Case Report
Case reports
Chemotherapy
Emergency medical care
Emergency medicine
Emergency service
Headaches
Hospitals
Laboratories
Leukemia
Lymphocyte receptors
Medicine
Nervous system
Oncology
Patients
Pediatric intensive care
Pediatrics
Vital signs
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Summary:A previously healthy 10-year-old girl presented to the emergency department (ED) with a headache and vomiting which resolved with oral NSAIDs. The patient returned two days later unable to ambulate with mental slowing and lower extremity bruising. Labs demonstrated marked leukocytosis, severe anemia and thrombocytopenia, and disseminated intravascular coagulation (DIC). Brain MRI showed multiple intracranial hemorrhages. A peripheral blood smear demonstrated blasts with many Auer rods. A diagnosis of acute promyelocytic leukemia (APL) was made and therapy including all-transretinoic acid (ATRA) was initiated. Neurologic status returned to baseline within 1 week in the pediatric intensive care unit.
ISSN:2090-648X
2090-6498
DOI:10.1155/2018/5241425