Abstract

BLANCO CAVIEDES, Ginna Charlotte; DEAZA FERNANDEZ, María Cristina  and  ALARCON AVILA, Claudia. Beyond the Diagnosis of Neonatal Congenital Leukemia. Rev. Med [online]. 2022, vol.30, n.2, pp.99-104.  Epub Nov 10, 2023. ISSN 0121-5256.  https://doi.org/10.18359/rmed.4307.

Neonatal congenital leukemia manifests within the first 30 days of life and is exceedingly rare in this age group, but more prevalent among patients with Down syndrome. Its etiology is primarily genetic but is also linked to alcohol consumption, marijuana, and smoking. Differential diagnosis should be made with transient myeloproliferative disorder, a benign condition that resolves spontaneously. We present a clinical case of a full-term newborn, 16 days old, initially displaying symptoms suggestive of necrotizing enterocolitis. However, upon admission to the neonatal unit, the patient exhibited a greatly distended abdomen with severe hepatosplenomegaly, severe leukocytosis, anemia, and thrombocytopenia, accompanied by 100% blasts and laboratory findings consistent with tumor lysis syndrome. Management was initiated with hyperhydration, allopurinol, and rasbu-ricase, but there was no improvement. Therefore, cytarabine was added. Flow cytometry indicated a megaloblastic pattern, indicative of myeloid leukemia. The patient required hospitalization for a month and a half, during which expected complications might arise. However, it was considered that the newborn experienced transient myeloid disorder, given the satisfactory clinical evolution, with reduced symptoms and severe leukocytosis.

Keywords : hyperleukocytosis; hepatomegaly; splenomegaly; tumor lysis syndrome.

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