근골격계 증상으로 발현된 성인의 급성 골수성 백혈병 = A Case of Adult Acute Myeloid Leukemia Presenting with Musculoskeletal Manifestations

다국어 초록 (Multilingual Abstract)

Leukemia is a heterogenous group of neoplasms that arise from the malignant transformation of hematopoietic cells. The usual presentation is one of lethargy, pallor, fever, purpura, bleeding, etc, and all this is secondary to a decrease in the production of normal blood components. However, leukemia often manifests with musculoskeletal symptoms without a systemic presentation. Musculoskeletal symptoms that precede the recognition of leukemia are much less frequent in adults as compared to those in children, and this causes diagnostic confusion and a delayed diagnosis. We describe here a case of adult acute myeloid leukemia in which pain and weakness of the limbs were the main manifestations and these were suspected as being symptoms of musculoskeletal disease.

참고문헌 (Reference)

1 정경은, "골 침범이 동반된 소아 급성 백혈병의 임상양상" 대한소아과학회 43 (43): 806-813, 2000

2 Thomas LB, "The skeletal lesions of acute leukemia" 14 : 608-621, 1961

3 Wallendal M, "The discriminating value of serum lactate dehydrogenase levels in children with malignant neoplasms presenting as joint pain" 150 : 70-73, 1996

4 Révész T, "The adverse effect of prolonged prednisolone pretreatment in children with acute lymphoblastic leukemia" 55 : 1637-1640, 1985

5 Gur H, "Rheumatic manifestations preceding adult acute leukemia: characteristics and implication in course and prognosis" 101 : 1-6, 1999

6 Bernard EJ, "Patterns of abnormality on bone scans in acute childhood leukemia" 39 : 1983-1986, 1998

7 Georges JB, "Osteoarticular disorders of haematological origin" 14 : 307-323, 2000

8 Marsh WL Jr, "Osteoarticular and pulmonary manifestations of acute leukemia: case report and review of the literature" 57 : 385-390, 1986

9 Rogalsky RJ, "Orthopaedic manifestations of leukemia in children" 68 : 494-501, 1986

10 Sinigaglia R, "Musculoskeletal manifestations in pediatric acute leukemia" 28 : 20-28, 2008

11 Barbosa CM, "Musculoskeletal manifestations as the onset of acute leukemias in childhood" 78 : 481-484, 2002

12 Trapani S, "Incidence of occult cancer in children presenting with musculoskeletal symptoms: a 10-year survey in a pediatric rheumatology unit" 29 : 348-359, 2000

13 Bowen RJ, "Extremity pain in a child: a case report of leukemia" 71 : 293-296, 1999

14 Choi HS, "Bone scintigraphic findings in leukemic patients" 26 : 101-105, 1992

15 Jonsson OG, "Bone pain as an initial symptom of childhood acute lymphoblastic leukemia: association with nearly normal hematologic indexes" 117 : 233-237, 1990