Priapism as an Unusual Symptom of T-cell Acute Lymphoblastic Leukemia in a Pediatric Case.

Acute lymphoblastic leukemia (ALL) in pediatric patients typically presents with recognizable symptoms such as fever, pallor, and bone pain. However, atypical manifestations can complicate the diagnostic landscape. We present a unique case of a seven-year-old male with T-cell ALL whose presenting symptom was priapism. This case underscores the need for heightened awareness among healthcare professionals regarding the diverse clinical presentations of leukemia, emphasizing the importance of a multidisciplinary team approach for comprehensive evaluation and management. Our seven-year-old patient presented with priapism. A comprehensive diagnostic workup, including complete blood counts and subsequent bone marrow examination, led to the diagnosis of T-cell ALL. Given the rare presentation, a multidisciplinary team consisting of pediatric oncologists/hematologists, urologists, and other relevant specialists collaborated to formulate a tailored treatment plan. The patient received an intensified chemotherapy regimen, resulting in the resolution of priapism and hematologic improvement. Priapism as an initial presentation of T-cell ALL in a pediatric patient is an exceptional occurrence, necessitating a specialized and collaborative approach to diagnosis and management. This case report highlights the importance of interdisciplinary coordination involving pediatric oncologists and urologists in addressing the unique challenges posed by atypical leukemia presentations. The rarity of this manifestation emphasizes the need for further research to elucidate the underlying mechanisms and establish optimal management strategies for similar cases.

Methemoglobinemia due to nitric oxide therapy in a child after cardiac surgery.

A 5-month-old boy with trisomy 21 had repair of ventricular septal defect, atrial septal defect, and ligation of a patent ductus arteriosus. Due to severe pulmonary hypertension, NO inhalation was instituted postoperatively. Over the course of next few hours, he developed life-threatening methemoglobinemia. The condition once recognized was corrected with exchange blood transfusion. The management strategy is described with a brief review of the literature.