Clinical thinking and decision making in practice. a child with tachypnea and dyspnea
Van der Vlugt, A.H.; Bos, A.P.; Hoekstra, M.O.
Nederlands Tijdschrift Voor Geneeskunde 145(13): 625-627
2001
ISSN/ISBN: 0028-2162 PMID: 11305212 Document Number: 537358
A 6-year-old girl had been ill for a number of weeks, had fever for 5 days and complained of pain below the left costal arch and in the left shoulder, linked to the breathing. An unexplained tachypnoea was also present. The leukocyte differentiation showed 90% blasts; a bone marrow puncture then led to the diagnosis of acute non-lymphatic leukaemia, and hyperhydration and alkalinization were started. The patient died unexpectedly after a few days from massive leukostasis in pulmonary arteries. If vital functions are impaired, it should always be attempted to find an explanation, for which an underlying disease may serve as a guideline.