Pancreatitis in Acute Lymphoblastic Leukemia

Putu Yudi Adnyani, I. Wande, S. Herawati
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Abstract

Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of heartburn accompanied by increased levels of pancreatic enzymes. Acute pancreatitis in acute lymphoblastic leukemia in addition to being caused by therapy can also be caused by other factors. 13-year-old female patient with a diagnosis of acute lymphoblastic leukemia complained of heartburn which was felt through to the back. Patients also experience nausea, vomiting, decreased appetite, difficulty in bowel movements, and fever. Physical examination found an increase in body temperature, anemic eyes, multiple neck gland enlargement, and enlargement of the liver. The results of complete blood tests showed leukocytosis, anemia, and thrombocytopenia. The results of examination of bone marrow aspiration show a picture of the bone marrow in accordance with acute lymphoblastic leukemia (ALL-L2). Clinical chemistry tests showed an increase in amylase, lipase, SGOT, BUN, creatinine, LDH, ferritin, calcium, and procalcitonin. The patient has never received chemotherapy for the ALL. Acute pancreatitis in ALL in addition to being caused by administration of leukemia can also be caused by sepsis conditions which are complications of the ALL. ALL patients who experience acute pancreatitis in this case show a poor prognosis.
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急性淋巴细胞白血病并发胰腺炎
胰腺炎是胰腺实质的炎症,根据伴有胰酶水平升高的胃灼热症状诊断。急性淋巴细胞白血病的急性胰腺炎除了由治疗引起外,还可由其他因素引起。13岁女患者,诊断为急性淋巴细胞白血病,主诉胃灼热,感觉贯穿背部。患者还会出现恶心、呕吐、食欲减退、排便困难和发烧等症状。体检发现体温升高,眼睛贫血,颈部多个腺体肿大,肝脏肿大。全血检查结果显示白细胞增多、贫血和血小板减少。骨髓穿刺检查结果显示骨髓图像符合急性淋巴细胞白血病(ALL-L2)。临床化学检查显示淀粉酶、脂肪酶、SGOT、BUN、肌酐、LDH、铁蛋白、钙和降钙素原升高。该患者从未因急性淋巴细胞白血病接受过化疗。急性胰腺炎除了由白血病引起外,还可能由败血症引起,败血症是ALL的并发症。所有在本病例中经历急性胰腺炎的患者预后不良。
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