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2017, Number 2

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Rev Hematol Mex 2017; 18 (2)

Acute lymphoblastic leukemia associated with eosinophilia in a scholar patient

Bejarano-Malta F, Ramírez-Pineda S, Cáceres-Paredes J, Rodríguez-Paz N, Godoy-Mejía C, Peña-Hernández J

Language: Spanish
References: 18
Page: 85-91
PDF size: 227.76 Kb.


ABSTRACT

Acute lymphoblastic leukemia associated to eosinophilia represents a distinct clinical entity, rarely described in childhood, reported for the first time in 1973 by Spitzer and Garson. In medical literature there are approximately 45 cases documented. This paper reports the case of a 9 year-old female patient, who presented approximately one month of fever, not quantified, attenuated with acetaminophen, with 2 days of vomits, sickness, abdominal pain, astenia, anorexy. Tachycardia, no hepatomegaly, paleness (+), inguinal lymph nodes. Subsequently arthralgia in the ankles, wrists and phalanges. Heart: gallop rhythm of the heart, left upper extremity and ankles with swelling. Hematoocology Service evaluated peripheral blood smears observing predominance of eosinophils and scarce immature cells, for this reason a bone marrow aspirate and immunophenotype were made reporting: early pre B acute lymphoblastic leukemia with eosinophilia. Chemotherapy scheme consisted of: vincristine, doxorubicin, L-asparaginase, cyclophosphamide, purinethol, citosar, with prednisone and methotrexate intrathecal therapy followed by anticoagulant therapy. There are a few cases of lymphoblastic leukemia associated to eosinophilia with early pre B cells that complicates with cardiac pathology at the beginning of the disease; in this case at the moment of the recruit in the imaging studies there was pericardial effusion and while the disease advanced there was progressive deterioration, forming a thrombus, left ventricular dilatation of the heart and hypomotility.


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