Recurrent perichondritis as a debut «mask» of acute lymphoblastic leukemia in a young child (clinical case)

Abstract

The article provides a description of the clinical case of acute lymphoblastic leukemia in a 2-year-old child, which proceeded under the guise of а recurrent auricle perichondritis. The features of this case have been determined. The only clinical manifestation of this disease from the beginning was hyperplastic syndrome: during the first 3 months — only recurrent perichondritis, since 4th month of the sickness — lymph node hyperplasia, since 5th month — skin leukemids, arthritis, and damage of the second auricle. During the first 3 months of the disease, peripheral blood count was found within the age normal values, from 4th month the child had moderate leukocytosis, without anemia, thrombocytopenia, changes in the leukocyte formula. Hyperleukocytosis blast forms of leukocytes were detected on 6th month of the disease. Slow progression of the disease, insufficient alertness of doctors due to the atypical course of the disease and a lack of treatment effectiveness resulted in late diagnosis and significant delay in starting treatment. The importance of alertness of general practitioners and specialists in terms of hematologic diseases was emphasized in order to ensure the earliest possible diagnosis and prescription of the adequate therapy.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. The patient's parents gave informed consent to the study.