Concluded Case

haematological diagnosis

15 yr male having nausea vomiting weakness H/o raised bilirubin upto 2 .back to normal now

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Concluded answer

HEPATOMEGALY WITH ACUTE EOSINOPHILIC LEUKEMIA? (AML) BONE MARROW BIOPSY ONCOLOGIST OPINION

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LEUKOCYTOSIS..WITH.. EOSINOPHILIA.. ? EOSINOPHILIC LEUKEMIA.. ? HES .. NEED'S.. COMPLETE BLOOD CELLS COUNT.. BONE MARROW STUDY.. USG STUDY ABDOMEN.. HEMATOLOGIST OPINION..

Nausea and vomiting are not diseases, but rather are symptoms of many different conditions, such as infection ("stomach flu"), food poisoning, motion sickness, overeating, blocked intestine, illness, concussion or brain injury, appendicitis and migraines.

15/M..with gastritis complaint and this cbc report seems to be causing trouble .. actually this cbc report shows leukocytosis with lymphocytosis with mild neutropenia with eosinophilia..but there isnt look like any leukaemia. leukaemia r of two types..acute lymphoid leukaemia and acute myeloid leukaemia.. peripheral smear of blood isnt showing any blast cells or immature cells. since no clinical examination signs symptoms suggested. go for blood C/S.severe bacterial infection with antihelminthics medication. repeat cbc after one week. If possible kindly update this case. Interesting case.

Thanks for ur appreciation Dr Nitin bora..it is wonderful case,would be glad if u could update it..
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SUGGESTIVE. OF INFECTIVE HEPATITIS POSSIBLY SECONDARY. TO HEPATIC VIRAL. AND PARASITIC. INFECTIONS ACUTE EOSINOPHILIC. LEUKAEMIA

So the question is whether this is Hypereosinophilic syndrome from a hematological cause or if there a secondary cause. Secondary causes usually include parasitic infections, some lymphomas, drugs, and autoimmune disorders. please rule out secondary causes as they are more likely in 15 y/o patients. If there is no apparent secondary cause, then would send for flow-cytometry and FISH for FLIPI-PDGFR, PCR for BCR-ABL, and JAKV16F mutation. Also, a bone marrow biopsy may be able to give you more answers. If the patient is decompensating (heart failure) treat with high dose steroid with ivermectin to prevent overwhelming Strongyloides infection.

Leukaemia Ad Bone marrow biopsy

D/D- leukemia, or eosinophilic disorder with gastric involvement, requires further work up

EL. Leukaemia. Hes. Bone marrow study.

HEPATOMEGALY WITH ACUTE EOSINOPHILIC LEUKEMIA? (AML) BONE MARROW BIOPSY ONCOLOGIST OPINION