Features of the Diagnosis of the Onset of Acute Lymphoblastic Leukemia: Description of the Clinical Case

Abstract

Based on literature data, the frequency of neuroleukemia in acute leukemia at the time of admission of the patient to the clinic is no more than 10 % and can manifest itself with atypical symptoms in the form of peripheral neuropathies, sensory disorders, or paralysis of the cranial nerves due to infiltration of the nervous tissue by leukemic cells. Damage to the nervous system with the manifestation of neuroleukemia is most typical for acute lymphoblastic leukemia. Also, paralysis of the cranial nerves can occur with neoplasms, injuries, inflammation, vascular insufficiency. Thus, a delay in diagnosis leads to delayed treatment and significantly affects the outcome of the disease. The tactics of patient management differ significantly when neuroleukemia is detected in a patient. The aim of the work is to present a clinical observation of acute leukemia, the features of which are the manifestation of neuropathy of the lower extremities and the presence of meningeal symptoms, as the primary manifestation of this disease, more often this occurs during relapses. Materials and methods. To describe this case, the following were used: collection of anamnesis of the disease, complaints at the time of admission and laboratory and instrumental data conducted in the clinical diagnostic laboratory of the Sverdlovsk Regional Clinical Hospital No. 1 (SRCH No. 1; Ekaterinburg). Results. A clinical case of a patient with acute leukemia is presented, the primary manifestations of which were episodes of acute respiratory viral infection, neuropathy of the lower extremities and then meningeal symptoms. Since there was no positive dynamics during the examination and subsequent treatment, the patient was transferred to SRCH No. 1 for further examination. During his stay in the hospital, the patient underwent a wide range of laboratory and instrumental studies, which made it possible to establish a diagnosis of acute lymphoblastic leukemia and begin appropriate therapy.

Acknowledgments
The authors would like to express their gratitude to Irina A. Koryakina and Svetlana B. Kravchenko, Physicians of the Clinical Department of Laboratory Diagnostics at the Sverdlovsk Regional Clinical Hospital No. 1 (Ekaterinburg), for their assistance in selecting drugs for microscopy and reviewing and preparing the conclusions. The authors would also like to thank Grigory A. Tsaur, Dr. Sci. (Med.), Head of the Laboratory of Molecular Biology, Immunophenotyping, and Pathomorphology at the Regional Children’s Clinical Hospital (Ekaterinburg), for his advice on materials for the article.

For citation
Kaliberda JuM, Rodygina EV, Bazarnyi VV. Features of the diagnosis of the onset of acute lymphoblastic leukemia: Description of the clinical case. USMU Medical Bulletin. 2024;(3):7–16. (In Russ.). EDN: https://elibrary.ru/RIGXKW.