Shaukat Ali.
Atypical Clinical Presentation of Acute Lymphoblastic Leukemia (All) in THQ Hospital, Katlang.
Ophthalmol Update Jan ;15(1):37-40.

Objective of study: During my experience in clinical paediatrics, I have noticed a number of patients coming to hospital with atypical symptoms and signs which later turned out to be cases of All. Therefore I felt that a study of atypical clinical presentation of All would be of great help in the early diagnosis and referral of patients to Teaching Hospital for management. Background. Acute leukemia is the most common form of malignancy in childhood. It has an annual incidence of 42 per million white children and 24 per million black. It is more common in boys than in girls. In Pakistan unplanned industrialization is taking place and large numbers of leukemia patients are now reported to various hospitals. Study Design: Descriptive. Material and Method: This study was conducted in paediatric department of type THQ Hospital Katlang over a period of 3 years from June 2006 to June 2009.The diagnosis was suspected clinically and supported by peripheral smear and confirmed by bone marrow aspiration. Tests were done at a private clinical Laboratory, Peshawar. Cyto-chemical studies (PAS & Peroxidase) were used for the identification of the type of leukemia. During the study period 10 atypical cases of leukemia were diagnosed. These were from both sexes, different age group and mixed socio economic status. After the diagnosis and supportive treatment, cases were referred to teaching Hospitals at Peshawar, both at Lady Reading & Hayatabad Medical Complex. Results: Patients with atypical signs and symptoms of clinically suspected as cases of leukemia in OPD randomly. They were advised peripheral smear and suspected cases were referred to private clinical laboratory at Peshawar. During the study period ten atypical cases of leukemia were diagnosed in the age group of 1-10 years in children and were referred to tertiary care hospitals in Peshawar for management. Conclusion: During the study period ten atypical cases were detected. They were more common in 1-5 years age group and in poor socio economic status (70%).

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