Acute pancreatitis as presenting complication of Acute myeloid leukemia (A rare case and Literature Review)

Abstract

Pancreatitis is a rare manifestation of Acute myeloid leukaemia (AML) arising during or after onset of course of disease. It can be first and only manifestation of AML. AML is a type of blood cancer. Characterized by clonal proliferation of abnormal myeloid precursors and altered normal hematopoiesis. The world Health organization (WHO) classification retains the diagnostic threshold the infiltration of the bone marrow by more than 20% of non-lymphoidblasts.

We reported a case of AML discovered in a 36-year-old female admitted with chief complaints of pain epigastrium. On Clinical examination she was conscious co-operated  well oriented. Blood pressure: 110/70 mmHg, abdominal examination revealed epigastric tenderness, no organomegaly. CVS,  Respiratory system and neurological examination were within normal limit. On investigation amylase was 856/ UL and Lipase 690 U/L, USG abdomen suggestive of acute pancreatitis. Complete haemogram was done as base line investigation which revealed leukocytosis 1.30 lac/microlit,  Hb-8 gm, platelets 32 tuousands only. The blood smear revealed the presence of circulating Blast-28, Atypical cells32%, myelocytes 7% and metamyelocytes 6% and reduced platelets. The bone marrow aspiration and biopsy suggestive of AML. Myeloperoxidase staining was positive. The patient was diagnosed as Acute pancreatitis and managed symptomatically. After improvement she was referred to PGIMER Chandigarh for further management of AML.