Poster Presentation

PP-088 Neonatal acute leukemia presenting with skin involvement

Abstract

Aim Neonatal leukemia is a rare disease with an incidence rate of 1–5 per 1000000 live births. Leukemia cutis occurs in 25–30% of infants with leukemia. Neonatal leukemia cutis presents within the first four weeks of life. It often has a ‘blueberry muffin baby’ appearance of magenta-colored nodules affecting almost any skin area. Here, a case of neonatal leukemia with blueberry muffin was presented due to its rarity.

Material and Method We report a 20-day-old male baby with a blueberry muffin appearance and decreased activity. He was born at 39 weeks gestation by cesarean section as APGAR of 8–10 and a weight of 4020 g from a 25-year-old gravida 1 mother. The patient had no additional features in his medical and family history. Physical examination revealed a weight of 4020 g (50–90p), a height of 52 cm (50–90p), a head circumference of 37 cm (90p), blueberry muffin rash (figure 1) on the trunk and proximal extremities, hepatosplenomegaly. Laboratory studies revealed a white blood cell count of 1048x109/L, hemoglobin of 8.5 g/dL, and platelet count of 49.6x109/L. Diffuse blastic cells were observed in the microscopic examination of the peripheral blood smear.

Abstract PP-088 Figure 1
Abstract PP-088 Figure 1

Blueberry muffin.

Results Erythrocyte and platelet transfusions were performed. The patient underwent leukapheresis once, and the white blood cell count was reduced to 325x109/L. The B-acute lymphoblastic leukemia was detected in the patient according to diagnostic tests. The 11q23 translocation was detected positive in the genetic tests. The patient was started on a chemotherapy protocol. The patient, who did not respond adequately to chemotherapy and developed septic shock and respiratory distress during follow-up, died at the age of 55 days.

Conclusions Congenital leukemia is a disease that is rare in the first month of life and has a poor prognosis. Skin lesions can often be the initial symptom. Skin findings in infancy should be evaluated from this perspective.

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