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以急性胰腺炎为急性髓系白血病首发表现的罕见病例。

A Rare Case of Acute Pancreatitis as an Initial Presentation of Acute Myeloid Leukemia.

作者信息

M Yashwanth, P Arun, S V Sanjay, Shetty Samarth V, N C Naveen

机构信息

General Medicine, Karnataka Institute of Medical Sciences, Hubballi, IND.

出版信息

Cureus. 2024 Apr 26;16(4):e59108. doi: 10.7759/cureus.59108. eCollection 2024 Apr.

Abstract

Acute pancreatitis is a rare manifestation of acute myeloid leukemia which can be a presentation at the initial diagnosis or during or after the onset of the disease. Acute myeloid leukemia occurs due to the abnormal proliferation of undifferentiated hematopoietic stem cells in the bone marrow which alter the normal hematopoiesis. We report the case of a 32-year-old male admitted with a one-month history of fever and backache, followed by 15 days of blackish stool discoloration and two days of abdominal pain and reduced urine output. On clinical examination, he was hypoxic with respiratory distress with epigastric tenderness. Blood investigations and imaging were consistent with acute pancreatitis. A complete blood count with peripheral smear showed severe normocytic normochromic anemia and an increased myeloid series containing 50% myeloblasts and 30% monoblasts. Additionally, some cells displayed cytoplasmic vacuolations, with a reticulocyte count of 2%. These findings were suggestive of acute myeloid leukemia M5. Due to the poor Glasgow Coma Scale (GCS), he was intubated and placed on mechanical ventilation. Unfortunately, he did not improve despite treatment and succumbed to the illness.

摘要

急性胰腺炎是急性髓系白血病的一种罕见表现,可在疾病初诊时、发病期间或发病后出现。急性髓系白血病是由于骨髓中未分化造血干细胞异常增殖,从而改变了正常造血过程所致。我们报告一例32岁男性患者,有1个月发热和背痛病史,随后出现15天黑便,以及2天腹痛和尿量减少。临床检查发现,他存在低氧血症,伴有呼吸窘迫和上腹部压痛。血液检查和影像学检查结果均符合急性胰腺炎。全血细胞计数及外周血涂片显示严重正细胞正色素性贫血,髓系细胞比例增加,其中原始粒细胞占50%,原始单核细胞占30%。此外,一些细胞出现细胞质空泡化,网织红细胞计数为2%。这些发现提示为急性髓系白血病M5。由于格拉斯哥昏迷量表(GCS)评分低,他被插管并接受机械通气。不幸的是,尽管接受了治疗,他的病情仍未改善,最终因病死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad85/11129800/bc2f2c4ce758/cureus-0016-00000059108-i01.jpg

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