Leucemia linfoblastica acuta all’esordio: quando nel dubbio è meglio fare…

Acute lymphoblastic leukemia is the most common malignancy diagnosed in children. We report the case of a female patient presenting with asthenia and limb pain when admitted to our Operative Unit of Pediatrics. Laboratory studies showed high levels of lactic dehydrogenase, erythrosedimentation velocity and C reactive protein. These findings were potentially confusing taking into account the apparent wellness of the patient. Based on the suspect of a possible lymphoproliferative disorder, bone marrow aspirate was performed and it revealed a complete invasion by lymphoblasts. We conclude that it is important to consider this diagnostic scenario when we take care of children presenting with few and aspecific symptoms, together with high inflammatory values and other indexes, but with an uneventful blood count.