Acute Leukemia in Children

Cooke, Jean V.

doi:10.1001/jama.1933.02740310016004

Cited by 78 publications

(12 citation statements)

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“…T h e frequency of reported articular manifestations in acute leukemia has varied from 12 to 65% in different series (2,10,11). Our finding of 16.6% falls in the lower range of these widely varying figures.…”

Section: Discussion Acknowledgmentmentioning

confidence: 99%

The arthritis of leukemia

Spilberg

Meyer

1972

Arthritis & Rheumatism

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Arthritis related to the primary disease was detected in 10 of 74 (13.5% patients seen primarily for leukemia [2 of 12 patients with acute (16.6% and 8 of 62 (12.4%) with chronic leukemia]. To these were added 18 ad ditional patients previously diagnosed of having arthritis of leukemia.Clinical analyses of 28 patients with arthritis of leukemia showed that the arthritis of acute leukemia was commonly asymmetric, additive, polyarticular and often part of the initial manifestation of the disease. The arthritis of chronic leukemia was similar t o the acute but was often symmetric and usually appeared as a late manifestation. X-ray films of affected joints were abnormal in 7 patients. Mild hyperuricemia was found in 15.8%, rheumatoid factor in none and antinuclear antibodies in 11% of patients with arthritis of leukemia. Leukemic infiltration of the synovial membrane was found in all 3 of the patients who underwent synovial biopsy and is believed to be the cause of the arthritis.Although arthritis is a known manifestation of acute leukemia (1-5), its occurrence in chronic leukemia is not well recognized ( 6 , 7 ) , and its prevalence has not been reported. This study describes the clinical characteristics and frequency of joint manifestations in a group of patients with chronic and acute leukemia. The incidence of rheumatoid factor, hyperuricemia, antinuclear antibodies and roentgenogram abnormalities was determined. Further, histologic examinations of synovial biopsies were performed in 3 patients.

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Section: Discussion Acknowledgmentmentioning

confidence: 99%

The arthritis of leukemia

Spilberg

Meyer

1972

Arthritis & Rheumatism

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“…Neutropenic enterocolitis was first reported as submucosal hemorrhage and appendiceal perforation in children with leukemia in 1933 (4). Neutropenic enterocolitis may involve the intestinal mucosa of terminal ileum, ascending colon and cecum.…”

Section: Introductionmentioning

confidence: 99%

Neutropenic Enterocolitis in Lung Cancer: A Report of Two Cases and a Review of the Literature

et al. 2005

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The first patient, a 68-year-old woman, presented neutropenic fever and hemorrhagic diarrhea on the sixth day of a combination chemotherapy of carboplatin and paclitaxel. The second patient, a 30-year-old man, presented neutropenia and diarrhea on the tenth day of the second cycle of a combination chemotherapy of cisplatin and vinorelbine. In both patients, abdominal computed tomography scan showed thickening of the colon wall and pericolic edema, and the ultrasonography revealed echogenic thickening of the colon walls. These findings confirmed the diagnosis of neutropenic enterocolitis. After the treatments, we changed the anticancer drug regimen; and successfully achieved partial responses.

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“…El proceso patológico se encuentra directamente relacionado con cambios intrínsecos en el íleon, el ciego y apén-dice cecal. Estudios inmunohistoquímicos de intestino en pacientes con leucemia y neoplasias sólidas han mostrado infiltración de la serosa y mucosa por células linfoproliferativas anómalas que suelen ulcerarse durante el tratamiento quimioterapéutico 1,3,4,6 . La tiflitis necrosante se presenta con mayor frecuencia en niños y adultos con neoplasias hematológicas, en los que la neutropenia es el principal factor de riesgo para el desarrollo de lesiones intestinales 1 ; sin embargo, se ha descrito y asociado a otras condiciones como la anemia aplásica, neutropenia cíclica, trasplante de medula ósea, uso crónico de sulfasalazina y síndrome de inmunodeficiencia adquirida 7,8 .…”

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“…El diagnóstico clínico representa la prueba más importante en colitis neutropénica. La presencia de síntomas abdominales en pacientes neutropénicos alertan acerca del posible desarrollo de tiflitis, mientras que las imágenes permiten valorar el grado de inflamación de la pared intestinal, la presencia de líquido libre en cavidad abdominal o la distensión de asas 1,2,4 . El tratamiento de la colitis neutropénica es controvertido; las aproximaciones terapéuti-cas actuales derivan de pequeñas series de casos en donde se describen intervenciones médicas y quirúrgicas [8][9][10][11] .…”

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