[Clinical thinking and decision making in practice. A child with tachypnea and dyspnea].
A 6-year-old girl had been ill for a number of weeks, had fever for 5 days and complained of pain below the left costal arch and in the left shoulder, linked to the breathing. An unexplained tachypnoea was also present. The leukocyte differentiation showed 90% blasts; a bone marrow puncture then led to the diagnosis of acute non-lymphatic leukaemia, and hyperhydration and alkalinization were started. The patient died unexpectedly after a few days from massive leukostasis in pulmonary arteries. If vital functions are impaired, it should always be attempted to find an explanation, for which an underlying disease may serve as a guideline.
van der Vlugt
A H
AH
Academisch Ziekenhuis/Beatrix Kinderkliniek, Groningen.
Bos
A P
AP
Hoekstra
M O
MO
D001856:Bone Marrow Examination; D002648:Child; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D006985:Hyperventilation / Q000209:etiology; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis*; D018921:Leukostasis / Q000209:etiology