以高钙血症为首发症状的儿童急性淋巴细胞白血病一例

Hypercalcemia as the first manifestation of childhood acute lymphoblastic leukemia:a case report

急性淋巴细胞白血病(ALL)是儿童期发病率最高的恶性肿瘤,主要表现为发热、面色苍白、乏力及出血等症状,常常累及肝、脾、淋巴结及纵膈。该文报道1例5岁ALL男性患儿,其因间断呕吐半个月就诊。患儿以高钙血症为首发症状,体格检查肝、脾及淋巴结无肿大,外周血常规显示白细胞分类无明显改变,最后经骨髓细胞形态学检查及流式细胞学检测明确ALL诊断。该例是以高钙血症为首发症状的ALL,临床罕见,可为临床诊治提供参考。

Acute lymphoblastic leukemia(ALL)is a malignant tumor with the highest incidence during childhood.ALL is mainly characterized with fever,pale face,fatigue and bleeding,etc.,which is primarily involved with the liver,spleen,lymph nodes and mediastinum.Here,we reported a 5-year-old boy diagnosed with ALL and he was admitted due to intermittent vomiting.He presented with hypercalcemia as the first manifestation.Physical examination showed no liver,spleen and lymph node enlargement.Peripheral blood test revealed no significant changes in the classification of white blood cells.Finally,the diagnosis of ALL was confirmed by bone marrow cell morphological examination and flow cytometry.This case of ALL with hypercalcemia as the first presentation is rare in clinical practice,providing reference for clinical diagnosis and treatment.