Mamunur Akm, Abdullah Almamun, Ham Nazmul Ahasan, Ch Rasul.
Leukemia mimicking juvenile rheumatoid arthritis
Pak J Med Sci Jan - Mar 2005;21(1):85-7.
Khulna Medical College, Bangladesh

A 9 years old boy was admitted in pediatric unit of Khulna Medical College Hospital with the complaints of fever for 4 months, pain and swelling of different joints for the same duration and itching of the whole body for 10 days. He had a history of fluctuating joint symptoms with morning stiffness. On examination, he was mildly anaemic, increased temperature with cervical and inguinal lymphadenopathy, small joint arthritis and hepatospleenomegaly. Initially it was clinically thought to be a case of systemic Juvenile Rheumatoid Arthritis (JRA). On investigation, WBC count was 11,700/cumm, N- 41% L- 55%, E-04%, ESR -95mm in the 1st hour, peripheral blood film (PBF) was normal. RA test was negative, ASO titer was 200 units. Patient was being treated as JRA and was kept for observation. After three months the boy became severely anaemic with haemorrhagic manifestations and was read-mitted. Peripheral blood film (PBF) and bone marrow aspiration was in favor of Acute Lym-phoblastic Leukemia (ALL). Management was given according to the chemotherapeutic schedule. The boy improved well and was under follow up.

Category: Case Reports
Keywords: Leukemia. Rheumatoid Arthritis. Arthritis.

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