title: Atypical Presentation of Acute Lymphoblastic Leukemia in a 7 Year Old Child.
abstract: Seven year child, who had intussusception 4 month before, readmitted for fever and walking difficulty. On examination, child had mild pallor and kyphosis of the spine but no organomegaly, lymphadenopathy or bone pain . Further evaluation revealed hypercalcemia, diffuse osteoporosis with vertebral fracture. Peripheral smear showed no blasts or pancytopenia. Bone marrow aspiration turned out to be a pre B cell ALL. This child had many atypical presentations like intussusception, osteoporosis, vertebral collapse and hypercalcemia without any classical features of ALL.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India.
authors.forename: C G
authors.initials: CG
authors.lastname: Delhi Kumar
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Biswal
authors.affiliation: Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India.
authors.forename: Smita
authors.initials: S
authors.lastname: Kayal
keywords: Acute lymphoblastic leukemia; Hypercalcemia; Intussusceptions; Osteoporosis