ESPE Abstracts (2019) 92 P3-45

Acute Lymphoblastic Leukemia;Atypically Presenting with Sever Hypercalcemia in a Palestinian Child

Hasan Eideh1,2,3, Mahdi Zaid2, Hani Saleh3, Shorouq Abu Alrub 1

1Palestinian Medical Complex, Ramallah, Palestine. 2Alanajah Hospital, Nablus, Palestine. 3Augusta Victoria Hospital, Jerusalem, Palestine

Severe hypercalcemia with total serum calcium concentrations above 15 mg/dL is a serious nonspecific life-threatening emerging disorder. Hypercalcemia usually results in nonspecific classic gastrointestinal and skeletal symptoms as anorexia, nausea, weakness, polyuria, constipation and bone pain. It can be associated with metabolic, nutritional, inflammatory, genetic or malignant disorders, or can be drug-induced. Malignancy related hypercalcemia develops more aggressively and rapidly than hypercalcemia related to other conditions. Among hematological malignancies, hypercalcemia is common in lymphoma and multiple myeloma; however, it is rare in acute and chronic leukemias, especially in children. Hypercalcemia usually presents as a late complication in childhood leukemia. Here, we report a 10-year-old Palestinian female child who initially presented with severe hypercalcemia (Ca 17.8 mg/dL) and low serum parathormone, and was diagnosed to have acute lymphoblastic leukemia in the absence of circulating blasts in the peripheral blood smear.Key words: Hypercalcemia, hematological malignancy, Leukemia, circulating blasts

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