Difficult acute lymphoblastic leukaemia diagnosis in a paediatric patient with mixed presentation of COVID-19 acute respiratory failure and multisystemic inflammatory syndrome

BMJ Case Rep. 2022 May 20;15(5):e248478. doi: 10.1136/bcr-2021-248478.

Abstract

New diagnoses of leukaemia and other malignancies are recently being made in paediatric patients with COVID-19. The rates of mortality and morbidity in some of these children are expected to be higher. In new cases, concurrent diagnosis can be difficult because multisystemic inflammatory syndrome (MIS-C) and malignancies have similar clinical presentations. We present the case of a preteenage child where the diagnosis of leukaemia was complicated and delayed by a multisystem involvement and an inconclusive bone marrow study. Clinical teams managing children with COVID-19 and MIS-C should suspect leukaemia and other malignancies when the clinical course is complicated and bone marrow suppression is persistent. Prompt diagnosis will allow start of treatment on time, minimising complications.

Keywords: COVID-19; Paediatric intensive care; Paediatric oncology.

Publication types

  • Case Reports

MeSH terms

  • COVID-19* / complications
  • Child
  • Humans
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / diagnosis
  • Respiratory Distress Syndrome*
  • Respiratory Insufficiency*
  • Systemic Inflammatory Response Syndrome / diagnosis

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related