MASSIVE PNEUMONIA AND PANCYTOPENIA LEADING TO THE DIAGNOSIS OF ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILD – A CASE REPORT AND A REVIEW OF THE LITERATURE

Abstract

Acute lymphoblastic leukemia (ALL) is one of the most common type of malignancies in children, but at the same time one of the cancers with the best prognostic. Transient pancytopenia has been described to be a very rare entity defined as a preleukemic condition in children and adolescents. We present the case of a 2-year-old male, with a 2-week history of respiratory tract infection, without any improvement after antibiotic therapy, admitted in our clinic with fever, influenced general status, productive cough, intense pallor, palpebral edema and perianal abscess. The laboratory findings revealed severe anemia, mild leukopenia and increased inflammatory biomarkers. The thoracic radiography pointed out a massive right pneumonia. The child was discharge after 3 weeks of wide spectrum antibiotics, presenting a favorable evolution. The follow-up CBC count at approximately 2 weeks from discharge revealed severe leukocytosis, and the immunophenotyping exam of the bone marrow established the diagnosis of pre-B cell type acute lymphoblastic leukemia. All patients treated for pancytopenia must benefit by a proper long-term monitoring in order to rule out the afterwards development of a potential ALL.

Keywords

• pneumonia
• child
• acute lymphoblastic leukemia
• pancytopenia