Errors in the diagnosis of acute leukemia in infants (clinical observations)

Acute leukemia accounts for up to 30% of all diseases of the hematopoietic and lymphoid systems in children. The initial period of leukemia is characterized by polymorphism of clinical symptoms, which makes it difficult to timely diagnose and treat this pathology. The reasons for the treatment of pa...

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Main Authors: G. A. Kharchenko, O. G. Kimirilova
Format: Article
Language:Russian
Published: Open Systems Publication 2023-02-01
Series:Лечащий Врач
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Online Access:https://journal.lvrach.ru/jour/article/view/1015
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author G. A. Kharchenko
O. G. Kimirilova
author_facet G. A. Kharchenko
O. G. Kimirilova
author_sort G. A. Kharchenko
collection DOAJ
description Acute leukemia accounts for up to 30% of all diseases of the hematopoietic and lymphoid systems in children. The initial period of leukemia is characterized by polymorphism of clinical symptoms, which makes it difficult to timely diagnose and treat this pathology. The reasons for the treatment of patients with leukemia for medical help, to doctors of various specialties, are: the presence of fever, hemorrhagic syndrome, increasing weakness, anemia, enlarged lymph nodes of the liver, spleen, pain in the joints and bones, impaired stool, etc. The article presents literature data and own observations of acute lymphoblastic leukemia in infants hospitalized in an infectious disease hospital with referral diagnoses: mumps; Intestinal infection – enteritis. The description of the clinical symptoms and the course of the disease is presented in the form of an analysis of the clinical situation for the purpose of medical education and differential diagnosis with mumps infection and enteritis of infectious etiology. An analysis of the clinical symptoms that a patient had with a referral diagnosis of mumps made it possible to establish significant deviations from the usual course of mumps infection, already at the initial request for medical help. Unilateral mumps submaxillitis is rare. More often both glands are affected in combination with parotid gland involvement. Widespread tissue edema is more characteristic of submandibular lymphadenitis rather than submaxillitis, which, in combination with hepatomegaly, testified against mumps infection. In a child with a referral diagnosis of intestinal infection, enteritis, the presence of lymphadenopathy, hemorrhagic syndrome, hepatosplenomegaly, with a mild intestinal syndrome, cast doubt on this diagnosis. Intestinal damage in leukemia is common and is caused by enteropathy syndrome, due to extramedullary lesions with hemorrhages in the intestinal mucosa, activation of opportunistic bacteria that make up the intestinal microflora. The reason for the errors in the diagnosis of leukemia, in the above observations, was the lack of an analysis of clinical symptoms, which would allow to establish discrepancies between the patient's symptoms and the proposed diagnosis. A one-sided approach to assessing the clinical symptoms that patients had, the lack of alertness of doctors in terms of blood diseases, were the reasons for the erroneous diagnosis during the initial treatment of patients for medical care.
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spelling doaj-art-2c6a72c7b158465fa2eef40f0ed4823a2025-08-03T13:02:55ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812023-02-010171010.51793/OS.2023.26.1.0011010Errors in the diagnosis of acute leukemia in infants (clinical observations)G. A. Kharchenko0O. G. Kimirilova1Federal State Budgetary Educational Institution of Higher Education Astrakhan State Medical University of the Ministry of Health of the Russian FederationFederal State Budgetary Educational Institution of Higher Education Astrakhan State Medical University of the Ministry of Health of the Russian FederationAcute leukemia accounts for up to 30% of all diseases of the hematopoietic and lymphoid systems in children. The initial period of leukemia is characterized by polymorphism of clinical symptoms, which makes it difficult to timely diagnose and treat this pathology. The reasons for the treatment of patients with leukemia for medical help, to doctors of various specialties, are: the presence of fever, hemorrhagic syndrome, increasing weakness, anemia, enlarged lymph nodes of the liver, spleen, pain in the joints and bones, impaired stool, etc. The article presents literature data and own observations of acute lymphoblastic leukemia in infants hospitalized in an infectious disease hospital with referral diagnoses: mumps; Intestinal infection – enteritis. The description of the clinical symptoms and the course of the disease is presented in the form of an analysis of the clinical situation for the purpose of medical education and differential diagnosis with mumps infection and enteritis of infectious etiology. An analysis of the clinical symptoms that a patient had with a referral diagnosis of mumps made it possible to establish significant deviations from the usual course of mumps infection, already at the initial request for medical help. Unilateral mumps submaxillitis is rare. More often both glands are affected in combination with parotid gland involvement. Widespread tissue edema is more characteristic of submandibular lymphadenitis rather than submaxillitis, which, in combination with hepatomegaly, testified against mumps infection. In a child with a referral diagnosis of intestinal infection, enteritis, the presence of lymphadenopathy, hemorrhagic syndrome, hepatosplenomegaly, with a mild intestinal syndrome, cast doubt on this diagnosis. Intestinal damage in leukemia is common and is caused by enteropathy syndrome, due to extramedullary lesions with hemorrhages in the intestinal mucosa, activation of opportunistic bacteria that make up the intestinal microflora. The reason for the errors in the diagnosis of leukemia, in the above observations, was the lack of an analysis of clinical symptoms, which would allow to establish discrepancies between the patient's symptoms and the proposed diagnosis. A one-sided approach to assessing the clinical symptoms that patients had, the lack of alertness of doctors in terms of blood diseases, were the reasons for the erroneous diagnosis during the initial treatment of patients for medical care.https://journal.lvrach.ru/jour/article/view/1015acute lymphoblastic leukemiachildrenclinicdiagnosis
spellingShingle G. A. Kharchenko
O. G. Kimirilova
Errors in the diagnosis of acute leukemia in infants (clinical observations)
Лечащий Врач
acute lymphoblastic leukemia
children
clinic
diagnosis
title Errors in the diagnosis of acute leukemia in infants (clinical observations)
title_full Errors in the diagnosis of acute leukemia in infants (clinical observations)
title_fullStr Errors in the diagnosis of acute leukemia in infants (clinical observations)
title_full_unstemmed Errors in the diagnosis of acute leukemia in infants (clinical observations)
title_short Errors in the diagnosis of acute leukemia in infants (clinical observations)
title_sort errors in the diagnosis of acute leukemia in infants clinical observations
topic acute lymphoblastic leukemia
children
clinic
diagnosis
url https://journal.lvrach.ru/jour/article/view/1015
work_keys_str_mv AT gakharchenko errorsinthediagnosisofacuteleukemiaininfantsclinicalobservations
AT ogkimirilova errorsinthediagnosisofacuteleukemiaininfantsclinicalobservations