5.0 of 4 Ratings
A 7-year-old boy is brought to his pediatrician by his mother for recent fatigue and intermittent fevers over the past month. She also reports that her son has appeared much paler recently. Vital signs at today's visit are within normal limits. Physical examination is significant for pallor, petechiae, lymphadenopathy, and hepatosplenomegaly. A complete blood count reveals anemia, thrombocytopenia, and neutropenia. A peripheral blood smear is shown in Figure A. Bone marrow aspiration reveals 47% lymphoblasts. Which of the following is associated with this patient's presenting condition?
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A 5-year-old boy presents to his primary care physician for recurrent colds, fatigue, and fussiness. Over the past several weeks, the child has been more fatigued and his parents state that “he always seems to be sick.” He otherwise is healthy and up to date on his vaccinations. They state that sometimes he complains about his bones hurting and they note that he is less playful. His temperature is 102°F (38.9°C), blood pressure is 92/60 mmHg, pulse is 115/min, respirations are 23/min, and oxygen saturation is 99% on room air. Physical exam is notable for diffuse non-tender lymphadenopathy. Abdominal exam reveals hepatosplenomegaly. Laboratory studies are ordered as seen below.Hemoglobin: 8.0 g/dLHematocrit: 23%Leukocyte count: 27,500/mm^3 with 35% lymphoblastsPlatelet count: 49,000/mm^3 Serum:Na+: 139 mEq/LCl-: 101 mEq/LK+: 4.0 Eq/LHCO3-: 24 mEq/LBUN: 16 mg/dLGlucose: 100 mg/dLCreatinine: 0.7 mg/dLWhich of the following is the most likely diagnosis?
Acute lymphoblastic leukemia
Acute myelogenous leukemia
Chronic myelogenous leukemia
Parvovirus B19 infection