GULHANE MEDICAL JOURNAL 2010 , Vol 52 , Issue 1
An unusual diagnosis in a child presenting with hypercalcemia: acute lymphoblastic leukemia
Mustafa Taşkesen, Nurettin Okur, Murat Söker, M.Ali Taş
Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır Hypercalcemia is a rare complication of acute lymphoblastic leukemia in childhood. We report a 4-year-old boy who presented with hypercalcemia and was diagnosed to have acute leukemia. The laboratory tests for main causes of hypercalcemia (Hyperparathyroidism, hypervitaminosis A and D, hyperthyroidism) were within normal limits. Hypercalcemia was treated with intravenous isotonic sodium chloride solution, furosemide and corticosteroids. In repeat laboratory tests performed on day 4 of admission, a normal complete blood cell count was found, but peripheral blood smear examination at this time revealed atypical lymphocytes. A bone marrow aspiration was performed, and 80% lymphoblasts were determined. The diagnosis of acute leukemia cannot be excluded in a patient with hypercalcemia and normal complete blood cell count and peripheral blood smear examination results. Repeat laboratory and detailed peripheral blood smear examinations are necessary to make a correct diagnosis in such cases. Keywords : Acute lymphoblastic leukemia, childhood, hypercalcemia