Hypereosinophilia as a Presenting Symptom of Acute Lymphoblastic Leukemia in a Child

Abstract

Hypereosinophilia is rare in children and represents primary or secondary conditions, the latter of which is associated with other diseases (parasitic infections and allergic, autoimmune, and neoplastic diseases). In small number of cases (< 1%) it is a part of the clinical presentation of acute lymphoblastic leukemia, the most common malignancy in children. More often hypereosinophilia precedes the symptoms of leukemia and hinders timely diagnosis, exposing patients in a high risk. In this report, a case of a child with acute lymphoblastic leukemia and hypereosinophilia is presented. The patient is a 30-month-old female, whose leukemia is preceded 2 weeks after hypereosinophilia. This symptom made the exact and timely diagnosis of oncological disease difficult. The further course of the disease was standard despite of delayed diagnosis and incomplete induction treatment due to the hepatic chemotoxicity. We present this case due to the rarity of hypereosinophilia in pediatric acute lymphoblastic leukemia. Every experience with such cases would be very useful for the improvement of the diagnosis of these patients. Moreover in our patient we did not find typical cytogenetic or molecular genetic abnormalities for this type of leukemia, and did not observe any clinical signs of organ complications specific for hypereosinophilia.

A Case of Precursor B-Acute Lymphoblastic Leukaemia Masquerading as Hypereosinophilia and Space Occupying Lesion in a 14-Year-Old Boy

“…Acute Lymphoblastic Leukaemia (ALL) with eosinophilia accounts for less than 1% of total cases of ALL and has been reported in both adult and paediatric populations. 4 This rare association was initially reported by Spitzer and Garson in 1973. 5 However, due to clinical resemblance with Hypereosinophilic Syndrome (HES) and masking of leukemic cells in peripheral blood, the diagnosis may be overlooked unless bone marrow biopsy or flow cytometry is performed.…”