Fever without a source : evolution of a diagnosis from Kawasaki disease to acute myelogenous leukaemia

© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted..

A previously healthy 11-month-old male patient presented with fever, abdominal pain and irritability. As part of an extensive evaluation for the cause of his fevers, an echocardiogram was performed and showed mildly dilated coronary arteries, leading to a diagnosis of incomplete Kawasaki disease (KD). He was treated with intravenous immunoglobulin (IVIG), defervesced and was discharged home. Two weeks later, he presented with anaemia initially attributed to haemolytic anaemia secondary to IVIG and received a red blood cell transfusion. However, his anaemia recurred 2  weeks later with leucocytosis, prompting a bone marrow aspirate 4  weeks after his diagnosis of KD. This demonstrated acute myelogenous leukaemia most consistent with acute megakaryocytic leukaemia. This case highlights the potentially subtle presentation of acute leukaemia and the need to keep an open mind and reconsider the initial diagnosis as new information comes to light in the care of an ill child.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:2017

Enthalten in:

BMJ case reports - 2017(2017) vom: 06. Mai

Sprache:

Englisch

Beteiligte Personen:

Lee, Begem [VerfasserIn]
Kofman, Christine D [VerfasserIn]
Tremoulet, Adriana H [VerfasserIn]
Kuo, Dennis John [VerfasserIn]

Links:

Volltext

Themen:

Cardiovascular medicine
Case Reports
Immunoglobulins, Intravenous
Journal Article
Paediatric oncology

Anmerkungen:

Date Completed 08.03.2018

Date Revised 25.02.2020

published: Electronic

Citation Status MEDLINE

doi:

10.1136/bcr-2016-217937

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM271637536