title: Eosinophilic presentation of acute lymphoblastic leukemia.
abstract: METHODS
  Male, 5 Primary Diagnosis: Rule-out appendicitis Co-existing Diseases: Acute lymphoblastic leukemia (ALL) Medication: Chemiotherapy Clinical Procedure: Chest CT • flow cytometry Specialty: Pediatrics' oncology • infection diseases.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  Leukemias are among the most common childhood malignancies. Acute lymphoblastic leukemia (ALL) accounts for 77% of all leukemias. In rare cases, ALL patients may present with eosinophilia.
  
  
  METHODS
  Here, a 5-year old boy was admitted to our hospital with a possible diagnosis of appendicitis. This patient's complete blood cell count demonstrated leukocytosis with severe eosinophilia. Following a 1-month clinical investigation, 2 bone marrow aspirations, and flow cytometry analysis, a diagnosis of acute lymphoblastic leukemia was proposed. Finally, the patient was transferred to the oncology ward to receive standard therapeutic protocol, which resulted in disease remission. After chemotherapy for 2 years, patient is successfully treated.
  
  
  CONCLUSIONS
  ALL is diagnosed by eosinophilia in rare cases. These patients need immediate diagnosis and intensive therapy due to worsened prognosis of ALL presenting as hypereosinophilia.
authors.affiliation: Department of Pediatrics, Tabriz University (Medical Sciences), Tabriz, Iran.
authors.forename: Azim
authors.initials: A
authors.lastname: Rezamand
authors.forename: Ziaaedin
authors.initials: Z
authors.lastname: Ghorashi
authors.forename: Sona
authors.initials: S
authors.lastname: Ghorashi
authors.forename: Nariman
authors.initials: N
authors.lastname: Nezami
keywords: acute lymphoblastic leukemia; eosinophilia; eosinophilic myelodysplasia