title: A case of acute lymphoblastic leukemia presenting as severe hypercalcemia.
abstract: A 9-year-old girl presented at the Pediatric Emergency Department with an acute onset of gastrointestinal symptoms due to hypercalcemia. Despite the absence of circulating blast, bone marrow biopsy was diagnostic of acute lymphoblastic leukemia. The hypercalcemia was initially treated with intravenous hydration and furosemide, and later on with bisphosphonates. However, the serum calcium levels normalized only after the beginning of specific chemotherapy. Hypercalcemia represents an emergency in children, and acute leukemia must be considered in its differential diagnosis, even when there are no circulating blasts.
authors.affiliation: Università Cattolica del Sacro Cuore, Policlinico A Gemelli, Rome, Italy. savabi@libero.it
authors.forename: Paola Sabrina
authors.initials: PS
authors.lastname: Buonuomo
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Marco
authors.initials: M
authors.lastname: Piastra
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Polidori
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaretti
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*