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Severe hypercalcemia as a form of acute lymphoblastic leukemia presentation in children

2015Journal article Open access
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dc.contributor.authorMartins, AL
dc.contributor.authorMoniz, M
dc.contributor.authorNunes, PS
dc.contributor.authorAbadesso, C
dc.contributor.authorLoureiro, HC
dc.contributor.authorDuarte, X
dc.contributor.authorAlmeida, HI
dc.date.accessioned2016-03-28T14:37:56Z
dc.date.available2016-03-28T14:37:56Z
dc.date.issued2015
dc.description.abstractHypercalcemia is a rare metabolic disorder in children and is potentially fatal. It has a wide differential diagnosis, including cancer. Here, we report the case of a previously healthy 3-year-old who was admitted to the emergency room with fatigue, hyporeactivity, fever and limping gait that had evolved over 5 days and that was progressively worsening. On examination the patient was unconscious (Glasgow coma score: 8). Laboratory tests indicated severe hypercalcemia (total calcium 21.39mg/dL, ionized calcium 2.93mmol/L) and microcytic anemia. Hyperhydration was initiated, and the child was transferred to the pediatric intensive care unit. Continuous venovenous hemodiafiltration with calcium-free solution was instituted, which brought progressive normalization of serum calcium and an improved state of consciousness. Zoledronate was administered, and metabolic and infectious causes and poisoning were excluded. The bone marrow smear revealed a diagnosis of acute lymphoblastic leukemia. Hypercalcemia associated with malignancy in children is rare and occurs as a form of cancer presentation or recurrence. Continuous venovenous hemodiafiltration should be considered in situations where there is imminent risk to life.pt_PT
dc.identifier.citationRev Bras Ter Intensiva. 2015 Dec;27(4):402-405pt_PT
dc.identifier.issn1982-4335
dc.identifier.urihttp://hdl.handle.net/10400.10/1591
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAssociação de Medicina Intensiva Brasileirapt_PT
dc.relation.publisherversionhttp://www.scielo.br/pdf/rbti/v27n4/en_0103-507X-rbti-27-04-0402.pdfpt_PT
dc.subjectHypercalcemiapt_PT
dc.subjectLymphoblastic leukemiapt_PT
dc.subjectChildpt_PT
dc.subjectHipercalcémiapt_PT
dc.subjectLeucemia linfoblásticapt_PT
dc.subjectCriançapt_PT
dc.titleSevere hypercalcemia as a form of acute lymphoblastic leukemia presentation in childrenpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceRio de Janeiropt_PT
oaire.citation.endPage405pt_PT
oaire.citation.startPage402pt_PT
oaire.citation.titleRevista Brasileira de Terapia Intensivapt_PT
oaire.citation.volume27pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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