Abstract
Background: Acute lymphoblastic leukemia (ALL) is an aggressive disease, which cause accumulation of immature early bone marrow hematopoietic cells known as blast cells.
Objective: To report an unusual presentation of a case of acute lymphoblastic leukemia in a Saudi female child.
Case Report: A four-Year old Saudi girl presented to Abha Maternal and Children's Hospital, Saudi Arabia, with repeated hematemesis. She had a history of fever reaching 39°C, which started 5 days earlier and responded to antipyretics, with no chills or rigor. On physical examination, the patient was conscious, alert, pale, lethargic, with mild dehydration. Res-piratory rate was 30 breaths/minutes, and the heart rate was 135 beats/minutes. Her growth parameters were normal. Bone marrow aspirations revealed being markedly infiltrated by blast cells, with marked reductions of all normal cells. There-fore, the case was diagnosed as acute leukemia, most probably acute lymphoblastic leukemia. She was referred to the Com-prehensive Cancer Center at King Fahad Medical City in Riyadh, to start her chemotherapy course for management of her condition.
Conclusions: Uncommon clinical presentations include hematemesis and diarrhea may lead to delay in diagnosis. Awareness of the uncommon signs and symptoms of childhood acute lymphatic leukemia helps in early diagnosis and proper management of patients.