title: Acute respiratory failure in 3 children with juvenile myelomonocytic leukemia.
abstract: BACKGROUND
  Juvenile myelomonocytic leukemia is a rare hematopoietic stem cell disease in children with features of both myelodysplasia and myeloproliferation. Extramedullary involvement has been reported and pulmonary involvement secondary to leukemic infiltration is an initial manifestation, which may result in acute respiratory failure.
  
  
  METHODS
  We present 3 children with juvenile myelomonocytic leukemia and suspected pulmonary leukemic cell infiltration who all also suffered from respiratory insufficiency. The differential diagnosis included asthma and infections.
  
  
  CONCLUSIONS
  In each case the patients improved rapidly after initiation of antileukemic treatment including 6-mercaptopurine or cytarabine.
authors.affiliation: Astrid Lindgren Children's Hospital, Huddinge, Karolinska University Hospital-Huddinge, Sweden. britt.gustafsson@ki.se
authors.forename: Britt
authors.initials: B
authors.lastname: Gustafsson
authors.forename: Marit
authors.initials: M
authors.lastname: Hellebostad
authors.forename: Marianne
authors.initials: M
authors.lastname: Ifversen
authors.forename: Birgitta
authors.initials: B
authors.lastname: Sander
authors.forename: Henrik
authors.initials: H
authors.lastname: Hasle
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D054429:Leukemia, Myelomonocytic, Juvenile / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D017254:Leukemic Infiltration / Q000175:diagnosis* / Q000628:therapy; D008168:Lung / Q000473:pathology*; D008297:Male; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology*