[Arthritis: an unusual and anticipatory clinical presentation of pediatric acute lymphoblastic leukemia. A case report].
BACKGROUND
Acute lymphoblastic leukemia initially shows osteoarticular manifestations. However, it is rare that it shows juvenile idiopathic arthritis (JIA) symptoms.


METHODS
A child with acute lymphoblastic leukemia initially misdiagnosed with malignant neoplasia and septic arthritis, and later on with juvenile idiopathic arthritis. The child had persistent articular pain and swelling despite treatment. Six months later, a full blood count revealed leukopenia and neutropenia with lymphocytosis. A bone marrow aspirate confirmed pre-B acute lymphoblastic leukemia with hypodyploidia.


CONCLUSIONS
This case initially showed typical signs of arthritis, and a diagnosis of acute lymphoblastic leukemia was ruled out, since the those clinical features and hematologic alterations characterizing this hematologic neoplasia.
Servicio de Reumatología Pediátrica, Instituto Nacional de Rehabilitación. Secretaría de Salud. México, D.F., Mexico.
Carolina
C
Duarte-Salazar
Concepción Guadalupe
CG
Santillán-Chapa
Garly Daniel
GD
González-Rosado
Norma
N
Marín-Arriaga
José Eugenio
JE
Vázquez-Meraz
D000782:Aneuploidy; D001168:Arthritis / Q000209:etiology*; D001170:Arthritis, Infectious / Q000175:diagnosis; D001171:Arthritis, Juvenile / Q000175:diagnosis; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D018450:Disease Progression; D004551:Elbow Joint / Q000473:pathology; D005260:Female; D006801:Humans; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000235:genetics / Q000473:pathology