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Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report

INTRODUCTION: Osteoporosis in children is rare and usually secondary to an underlying disease process whose diagnosis may be difficult to detect. Etiological factors responsible for osteoporosis secondary to chronic illness include immobility, pubertal delay and other hormonal disturbances. Rarely,...

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Autores principales: Salim, Hendra, Ariawati, Ketut, Suryawan, Wayan Bikin, Arimbawa, Made
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077677/
https://www.ncbi.nlm.nih.gov/pubmed/24885558
http://dx.doi.org/10.1186/1752-1947-8-168
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author Salim, Hendra
Ariawati, Ketut
Suryawan, Wayan Bikin
Arimbawa, Made
author_facet Salim, Hendra
Ariawati, Ketut
Suryawan, Wayan Bikin
Arimbawa, Made
author_sort Salim, Hendra
collection PubMed
description INTRODUCTION: Osteoporosis in children is rare and usually secondary to an underlying disease process whose diagnosis may be difficult to detect. Etiological factors responsible for osteoporosis secondary to chronic illness include immobility, pubertal delay and other hormonal disturbances. Rarely, it can be a manifestation of acute lymphoblastic leukemia. Most of the reported bone fracture incidences associated with acute lymphoblastic leukemia occur during the course of the chemotherapy, not at the point of the first symptoms of leukemic disease, as happened with the case presented here. CASE PRESENTATION: A 7-year-old Asian Balinese boy presented with back pain. His anteroposterior pelvic radiograph showed osteoporotic bone. A bone age study revealed growth failure of his metacarpals, phalanges and sesamoid. His total bone mass density was 97% age-match. However, a peripheral blood smear showed normochromic anemia with thrombocytopenia. Immunophenotyping of his peripheral blood revealed no dominant markers, but a bone marrow aspiration confirmed a diagnosis of acute lymphoblastic leukemia. CONCLUSIONS: Osteoporosis was the only manifestation of the child’s underlying acute lymphoblastic leukemia. Leukemia was diagnosed when his bone marrow was found to contain more than 25% blasts. Because of leucopenia, the immunophenotype failed to reveal a dominant marker in this case, thus we were unable to classify the acute lymphoblastic leukemia.
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spelling pubmed-40776772014-07-02 Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report Salim, Hendra Ariawati, Ketut Suryawan, Wayan Bikin Arimbawa, Made J Med Case Rep Case Report INTRODUCTION: Osteoporosis in children is rare and usually secondary to an underlying disease process whose diagnosis may be difficult to detect. Etiological factors responsible for osteoporosis secondary to chronic illness include immobility, pubertal delay and other hormonal disturbances. Rarely, it can be a manifestation of acute lymphoblastic leukemia. Most of the reported bone fracture incidences associated with acute lymphoblastic leukemia occur during the course of the chemotherapy, not at the point of the first symptoms of leukemic disease, as happened with the case presented here. CASE PRESENTATION: A 7-year-old Asian Balinese boy presented with back pain. His anteroposterior pelvic radiograph showed osteoporotic bone. A bone age study revealed growth failure of his metacarpals, phalanges and sesamoid. His total bone mass density was 97% age-match. However, a peripheral blood smear showed normochromic anemia with thrombocytopenia. Immunophenotyping of his peripheral blood revealed no dominant markers, but a bone marrow aspiration confirmed a diagnosis of acute lymphoblastic leukemia. CONCLUSIONS: Osteoporosis was the only manifestation of the child’s underlying acute lymphoblastic leukemia. Leukemia was diagnosed when his bone marrow was found to contain more than 25% blasts. Because of leucopenia, the immunophenotype failed to reveal a dominant marker in this case, thus we were unable to classify the acute lymphoblastic leukemia. BioMed Central 2014-05-28 /pmc/articles/PMC4077677/ /pubmed/24885558 http://dx.doi.org/10.1186/1752-1947-8-168 Text en Copyright © 2014 Salim et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Salim, Hendra
Ariawati, Ketut
Suryawan, Wayan Bikin
Arimbawa, Made
Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title_full Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title_fullStr Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title_full_unstemmed Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title_short Osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
title_sort osteoporosis resulting from acute lymphoblastic leukemia in a 7-year-old boy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077677/
https://www.ncbi.nlm.nih.gov/pubmed/24885558
http://dx.doi.org/10.1186/1752-1947-8-168
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