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CASE REPORT
Year : 2017  |  Volume : 6  |  Issue : 3  |  Page : 657-659

Back pain: An unusual manifestation of acute lymphoblastic leukemia – A case report and review of literature


1 Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
2 Department of Pediatrics, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Magatha Sneha Latha
Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical College, Porur, Chennai - 600 116, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.222020

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Acute lymphoblastic leukemia (ALL) presented with bone pain and leukopenia is a well-recognized complex. Bone and joint pain are seen as presenting symptoms in 25% of patients with acute leukemia, but generalized osteopenia and vertebral complications are less common. Back pain due to vertebral changes as an early feature has been infrequently reported. We report a case of a 9-year-old female child who presented with back pain for 3 weeks. Blood counts and peripheral smear were normal. X-ray of the spine showed wedge-shaped deformity in L3–L5 vertebrae. Magnetic resonance imaging of the spine confirmed the lytic lesions of L3–L5 vertebrae. Infective etiological evaluation was normal. Bone marrow aspiration revealed pre-B-cell lymphoblastic leukemia. She was started on ALL protocol and pain subsided within a week, and remodeling of the bony lesions could be seen 2 months later. This case highlights that spinal involvement may be a presenting feature despite normal peripheral blood counts.


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