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

• Published in: BMJ case reports Vol. 15; no. 5; p. e248478
• Main Authors: Domínguez-Rojas, Jesús Angel, Rojas-Soto, Ninoska, Vásquez-Hoyos, Pablo, Coronado Munoz, Alvaro J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 20.05.2022; BMJ Publishing Group
• Subjects: Case reports; Case Reports: Unusual presentation of more common disease/injury; Intensive care; Leukemia; Medical diagnosis; Multisystem inflammatory syndrome in children; Pediatrics; Respiratory failure; COVID-19; Paediatric intensive care; Paediatric oncology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-248478

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.