Fatih AYGÜN, Başak KOÇ, Fatma Deniz AYGÜN, Gül Nihal ÖZDEMİR, Bülent ZÜLFÜKAR, Halit ÇAM

Hiperkalsemi İçin Hemodiyafiltrasyon Uygulanan Akut Lenfoblastik Lösemi Vakası

Hiperkalsemi çocuklarda yetişkinlere göre daha az görü- len, genellikle bulantı-kusma, kilo kaybı, iştahsızlık gibi özgün olmayan belirtiler gösteren acil bir tıbbi durumdur. Şiddetli hiperkalsemi, çocuklarda malignitenin ender bir komplikasyonudur ve yaşamı tehdit edecek kadar ciddi olabilir. Bu makalede boynunda kitle yakınmasıyla başvu- ran, biyopsi sonrası kontrol biyokimyasında serum kalsi- yum düzeyinin 18.4 mg/dL saptanması üzerine yapılan incelemeler sonucu Pre B akut lenfoblastik lösemi ALL tanısı alan ve akut hiperkalsemisi için venövenöz hemodi- yafiltrasyon uygulanan 11 yaşında kız hasta sunulmuştur. Amacımız çocuklarda hiperkalsemi ayırıcı tanısında malig- nitenin unutulmaması gerektiğini anımsatmaktadır

Anahtar Kelimeler:

Hiperkalsemi, çocuk, akut lenfoblastik lösemi

A Case with Acute Lymphoblastic Leukemia Who Had Undergone Hemodiafiltration Treatment for Hypercalcemia

Hypercalcemia is a rarely seen medical emergency in child- ren compared with adults who present with nonspecific symptoms such as loss of appetite, nausea, vomiting, weight loss. Severe hypercalcemia is a rare complication of malig- nancy in children which can result in a life threatening con- dition. Herein, we report a 11- year -old girl presenting with a mass on her neck and hypercalcemia. Her serum calcium level was 18.4 mg/dL which necessitated biochemical analy- sis with resultant establishment of diagnosis of pre B acute lymphoblastic leukemia ALL and ensuing venovenous hemofiltration treatment for her acute hypercalcemia. Our aim is to remind that malignancies should not be overlooked in the differential diagnosis of pediatric hypercalcemia

Keywords:

Hypercalcemia, child, acute lymphoblastic leukemia,

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1. Stewart AF. Hypercalcemia associated with cancer. N Eng J Med 2005;352:373-9. http://dx.doi.org/10.1056/NEJMcp042806
2. Mundy GR, Ibbotson KJ, D’Souza SM, et al. The hypercalcemia of cancer. Clinical implications and pathogenic mechanisms. N Engl J Med 1984;310:1718-27. http://dx.doi.org/10.1056/NEJM198406283102607
3. Kerdudo C, Aerts I, Fatter S, et al. Hypercalcemia and childhood cancer: a 7-year experience. J Pediatr Hematol Oncol 2005;27:23-7. http://dx.doi.org/10.1097/01.mph.0000151932.47598.00
4. Becker KL. Principles and practice of endocrinology and metabolism. 3rd edn. Philadelphia. Lippincott Williams and Wilkins, 2001.
5. Shimonodan H, Nagayama J, Nagatoshi Y, et al. Acute lymphocytic leukemia in adolescence with osteolytic lesions and hypercalcemia mediated by lymphoblast-producing parathyroid hormone-related peptide: a case report and review of the literature. Pediatr Blood Cancer 2005;45:33-9.
6. Suva LJ, Winslow GA, Wettenhall RE, et al. A parathyroid hormon related protein implicated in malignant hypercalcemia: cloning and expression. Science 1987;237:893-6. http://dx.doi.org/10.1126/science.3616618
7. Trehan A, Cheetham T, Bailey S. Hypercalcemia in acute lymphoblastic leukemia: an overview. J Pediatr Hematol Oncol 2009;31:424-7. http://dx.doi.org/10.1097/MPH.0b013e3181a1c12b
8. Raimondi SC. Cytogenetics in acuteleukemia. In: Pui CH, ed. Childhood Leukemias. 1st ed. Cambridge: Cambridge University Press 2000:168-96