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急性白血病的诊断挑战:从牙痛到灾难性脑出血

Diagnostic Challenges in Acute Leukemia: From Dental Pain to Catastrophic Intracerebral Hemorrhage.

作者信息

Pinchuk Anatoli, Roch Stefan P, Mawrin Christian, Behme Daniel, Stein Klaus-Peter, Neyazi Belal, Mikusko Martin, Sandalcioglu Ibrahim Erol, Rashidi Ali

机构信息

Department of Neurosurgery, Otto von Guericke University, 39120 Magdeburg, Germany.

Department of Neuropathology, Otto von Guericke Unviersity, 39120 Magdeburg, Germany.

出版信息

Hematol Rep. 2025 Jul 23;17(4):36. doi: 10.3390/hematolrep17040036.

Abstract

: Acute leukemias are neoplasms of the hematopoietic system that are caused by the extensive proliferation of immature precursor cells ('blasts'), mainly in the bone marrow. They frequently manifest with vague and non-specific clinical symptoms, making early diagnosis particularly challenging. : This case report describes the clinical course of a female patient who initially sought dental care due to a persistent toothache-an atypical and misleading symptom. Subsequent investigations revealed a diagnosis of acute leukemia. Although the malignancy was identified promptly and the appropriate therapeutic measures were initiated, the disease progressed with alarming rapidity. The patient ultimately developed a massive intracerebral hemorrhage-a devastating complication likely related to leukemia-associated coagulopathy. Despite emergent neurosurgical intervention, the hemorrhage proved fatal. : This case highlights the critical need for heightened clinical suspicion in the presence of unusual symptoms and illustrates the complex interplay between hematologic malignancies and coagulopathic complications.

摘要

急性白血病是造血系统的肿瘤,由主要在骨髓中的未成熟前体细胞(“原始细胞”)大量增殖引起。它们常表现为模糊且非特异性的临床症状,使得早期诊断极具挑战性。 本病例报告描述了一名女性患者的临床病程,该患者最初因持续牙痛(一种不典型且具有误导性的症状)寻求牙科治疗。随后的检查显示诊断为急性白血病。尽管恶性肿瘤被迅速识别并启动了适当的治疗措施,但疾病进展迅速,令人震惊。患者最终发生了大量脑出血——这是一种可能与白血病相关凝血病有关的毁灭性并发症。尽管进行了紧急神经外科干预,但出血被证明是致命的。 本病例强调了在出现异常症状时提高临床怀疑的迫切需要,并说明了血液系统恶性肿瘤与凝血病并发症之间的复杂相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a47/12385712/f6a6f9827af3/hematolrep-17-00036-g001.jpg

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