title: Neutropenic enterocolitis as a presenting complication of acute lymphoblastic leukemia: an unusual case marked by delayed perforation of the descending colon.
abstract: Neutropenic enterocolitis (NE) is a life-threatening complication most commonly seen in patients receiving intensive chemotherapy for acute leukemia. The condition usually affects the terminal ileum, cecum, or ascending colon. In rare instances, NE may occur before the initiation of chemotherapy or involve more distal bowel. The authors report the case of a 2-year-old girl who had NE affecting the descending colon as a presenting complication of acute lymphoblastic leukemia. Despite aggressive medical interventions, including granulocyte infusions, she had a delayed bowel perforation that was managed successfully with surgery. This case highlights the challenges of treating patients who have NE as an initial manifestation of acute leukemia.
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Wilson
authors.forename: Aarati
authors.initials: A
authors.lastname: Rao
authors.forename: Monica
authors.initials: M
authors.lastname: Hulbert
authors.forename: Kerry P
authors.initials: KP
authors.lastname: Mychaliska
authors.forename: Lori
authors.initials: L
authors.lastname: Luchtman-Jones
authors.forename: D Ashley
authors.initials: DA
authors.lastname: Hill
authors.forename: Robert P
authors.initials: RP
authors.lastname: Foglia
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage; D002675:Child, Preschool; D003125:Colostomy; D044504:Enterocolitis, Neutropenic / Q000209:etiology* / Q000628:therapy; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007813:Laparotomy; D008727:Methotrexate / Q000008:administration & dosage; D008775:Methylprednisolone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D011994:Recombinant Proteins; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D001215:Asparaginase; D000069585:Filgrastim; D008775:Methylprednisolone; D008727:Methotrexate