Pathophysiology Case: P.D. is a 7-year-old girl who was brought to her physician
ID: 57013 • Letter: P
Question
Pathophysiology Case:
P.D. is a 7-year-old girl who was brought to her physician by her mother with complaints of general fatigue, anorexia, and unexplained bruises and "rash" for the past 2 weeks. Current Status: P.D.'s vital signs are: temperature 98.6; heart rate 92, blood pressure 90/60; respirations 18; height and weight in the 55th percentile. Her skin is warm, pale, and dry with bruising on the extremities and trunk. Examination of the skin reveals small petechial lesions on the arms and legs. There is no hepatosplenomegaly. There are three palpable non-tender lymph nodes in the submaxillary chain. Laboratory data: Hgb 8.8, HCT 26, RBC 3.1 million, WBC 45,000 with 10% blasts, platelets 50,000. A bone marrow aspiration, lumbar puncture, and other studies revealed acute lymphoblastic leukemia.
Answer the following questions based on the above information:
1)What cell type is abnormal in acute lymphoblastic leukemia?
2)What clinical signs and the given laboratory data suggest she has leukemia? Provide a physiological rationale for each sign and relate each finding to leukemia. Explain why each finding occurs in this disease.
Explanation / Answer
1) lymphoblasts
2) Her skin is warm, pale, and dry with bruising on the extremities and trunk. Examination of the skin reveals small petechial lesions on the arms and legs. This gives preliminary sign that the child may be suspected to have ALL.