Keywords: leukemia symptoms

    Onset leukemia abrupt onset or slow, and more rapid onset of child and adolescent psychiatric patients. Common initial symptoms include: fever, anemia, bleeding tendency or significant bone and joint pain. Slow onset persons, mostly elderly and young patients, the disease gradually progress. These patients with progressive fatigue, weakness, pale and flustered shortness of breath after exertion, lack of appetite, weight loss, or unexplained fever as the first symptom. In addition, a small number of patients with convulsions, blindness, toothache, gum swelling, pericardial effusion, lower limbs paraplegia as the first symptom onset.

    2, fever and infection

    A fever is one of the leukemia, the most common symptoms, and then the disease can occur at different stages and different degrees of heat and hot type. The main reason of the fever infections, including angina, stomatitis, perianal inflammation most commonly, pneumonia, tonsillitis, gingivitis, perianal abscess is more common. Inflammation of the ear can also be seen, enteritis, appendicitis, pyelonephritis, occurrence of sepsis, sepsis and other serious infections also.

    B infection pathogens bacteria common in the early stages of disease, mainly Gram-positive cocci. Virus infection is rare but often more dangerous, cytomegalovirus, measles or chicken pox virus infection complicated by pneumonia, should be noted.

    Bleeding bleeding is also a common symptom of leukemia, bleeding sites throughout the body, the skin, gums, nasal bleeding is the most common, may also have the retina, ear bleeding and intracranial, gastrointestinal, respiratory and other internal haemorrhage. Women with menorrhagia and more common, but the first symptom. AML, M3 and M5 subtypes is bleeding more serious, especially M3 patient complicated by disseminated intravascular coagulation (DIC) and intracranial hemorrhage and death.
     
    4 early, anemia can occur, a small number of cases in the first refractory anemia diagnosed before a few months or years, and later in the development of leukemia. Patients are often accompanied by fatigue, paleness, palpitations, shortness of breath, lower extremity edema and other symptoms. Anemia seen in various types of leukemia, but more common in elderly AML patients, many patients often as the first symptom of anemia.

    5, leukemia cell infiltration signs

    A, liver, splenomegaly, lymphadenopathy

    B, the nervous system: the main lesion bleeding and leukemia infiltration

    C, bone and joint: bone and joint pain is one of the important symptoms of leukemia, ALL more common.

    D, skin; may have two kinds of specific and non-specific skin lesions, the former manifested as rash, pustular, lumps, nodules, erythroderma, exfoliative dermatitis and other common leukemia in adult monocytes, the latter more performance skin ecchymosis, spots, etc..
     
    E, mouth: gum swelling, bleeding, leukemia infiltration more common in AML-M5, serious gum can be extremely hyperplasia, swelling spongiform surface ulceration easy bleeding.

    F, heart: the majority of the performance of myocardial leukemia infiltration, hemorrhage and epicardial bleeding, pericardial effusion.

    G, kidney: leukemia, kidney disease by up to 40% or more.

    H, gastrointestinal system: as nausea, vomiting, lack of appetite, bloating, diarrhea.

    I, lung and pleura: infiltration of the alveolar wall and lung clearance can also be infiltrating bronchial, pleural, vascular wall.

    J,: uterine, ovarian, testicular, prostate, etc. can be leukocyte infiltration. Female patients often have vaginal bleeding and menstrual irregularities. The male patient may have loss of libido.

    [Diagnostic criteria are not sick, we must conduct clinical diagnosis

    1, the clinical symptoms of abrupt fever, progressive anemia or significant bleeding, the whole body aches, fatigue.

    2, the signs of skin bleeding spots, sternal tenderness, lymph nodes, liver and spleen enlargement.
     
    3 Laboratory:

    A, blood leukocyte always obvious increase (or decrease), there may be primitive or naive cells.

    ≥ 30% of bone marrow bone marrow nucleated red blood cells accounted for all less than 50% of nucleated cells, primitive cells ≥ 30%, can be diagnosed as acute leukemia; such as bone marrow nucleated red blood cells ≥ 50% of the original cells in non-erythroid cells can be diagnosed as acute erythroleukemia.

    Differential diagnosis:

    A, aplastic anemia;

    B, myelodysplastic syndrome;
     
    C, malignant histiocytosis;

    D, idiopathic thrombocytopenic purpura

    Of leukemia Ten symptoms

    The sudden onset of leukemia onset more abrupt, short-term course of the disease, particularly children and young people more.

    The first symptom of fever acute leukemia mostly fever, can be expressed as remittent fever, continued fever, intermittent fever, or irregular fever, body temperature 37.5 ~ 40 ℃ or higher. When cold, but not chills.
     
    The bleeding is a common symptom of leukemia. Bleeding sites throughout the body, especially in the nose, mouth, gums, subcutaneous, fundus common, may also have intracranial, inner ear and internal bleeding.

    Anemia can occur early anemia, the performance of As for looking  white, dizziness, palpitations.
     
    Hepatosplenomegaly 50% of patients with leukemia hepatosplenomegaly, most significant hepatosplenomegaly acute lymphoblastic leukemia.

    The systemic broad swollen lymph nodes, lymph nodes is more common acute lymphoblastic leukemia and acute lymphocytic leukemia CLL significantly better than. Superficial lymph nodes in the neck, lower jaw, armpit, groin, etc., deep lymph nodes in the mediastinum and visceral nearby. Swollen lymph nodes generally the texture soft or medium hardness, smooth surface and no tenderness, no adhesion.

    Skin and mucosal lesions accompanied by leukemia, skin lesions, nodules, lumps, rash. The mucosal damage the performance of the nasal mucosa, respiratory mucosa and oral mucosa, etc. swelling and ulcers.

    Nervous system inflammation of the arachnoid, meninges, etc. leukocyte infiltration, is a lot like a brain tumor, meningitis, occurs in patients with increased intracranial pressure, meningeal irritation, paralysis of limbs, and other symptoms can occur.

    Bone and joint disease lesions after infiltration of the bone and joint, often occurs in bone and joint pain, manifested as the sternum, humerus, and shoulder, elbow, hip, knee, etc. appear dull pain, soreness and occasional pain. Children with acute lymphoblastic leukemia and multiple bone and joint tenderness.

    Other leukemia cells infiltration respiratory, digestive and urogenital system, as well as the orbit, the lacrimal gland and fundus, the patient may appear diffuse or nodular changes in the lungs, accompanied by pleural effusion, digestive disorders, proteinuria, hematuria, amenorrhea or excessive menstrual flow, proptosis, vision loss and other symptoms.

    A. leukemia symptoms
    
    1, the sudden onset of leukemia onset more abrupt, short-term course of the disease, especially children and youth.

    2, the first symptom of fever acute leukemia mostly fever, can be expressed as remittent fever, continued fever, intermittent fever, or irregular fever, body temperature at 37.5 ~ 40 ℃ or higher. When cold, but not chills.

    3, the bleeding is a common symptom of leukemia. Bleeding sites throughout the body, especially in the nose, mouth, gums, subcutaneous, fundus common, may also have intracranial, inner ear and internal bleeding.

    4 anemia early to anemia, performance  white complexion, dizziness, palpitations.

    Hepatosplenomegaly 50% of leukemia patients hepatosplenomegaly, hepatosplenomegaly acute lymphoblastic leukemia, the most significant.
     
    6, lymph systemic lymph nodes is more common acute lymphoblastic leukemia, acute lymphocytic leukemia CLL significantly better than. Superficial lymph nodes in the neck, lower jaw, armpit, groin, etc., deep lymph nodes in the mediastinum and visceral nearby. Swollen lymph nodes generally the texture soft or medium hardness, smooth surface and no tenderness, no adhesion.
     
    7, skin and mucosal lesions accompanied by leukemia, skin lesions, nodules, lumps, rash. The mucosal damage the performance of the nasal mucosa, respiratory mucosa and oral mucosa, etc. swelling and ulcers.
     
    Nervous system inflammation of the arachnoid, meninges, etc. can occur leukocyte infiltration, is a lot like a brain tumor, meningitis, occurs in patients with increased intracranial pressure, meningeal irritation, paralysis of limbs, and other symptoms.
     
    9, bone and joint disease lesions after infiltration of the bone and joint, often occurs in bone and joint pain, manifested as the sternum, humerus, and shoulder, elbow, hip, knee, etc. appear dull pain, soreness, occasional pain. Children with acute lymphoblastic leukemia and multiple bone and joint tenderness.

    10 other leukemia cells infiltrating the respiratory, digestive and urogenital system, as well as the orbit, the lacrimal gland and fundus, can occur in patients with diffuse or nodular changes in the lungs, accompanied by pleural effusion, digestive disorders, proteinuria, hematuria, amenorrhea or excessive menstrual flow, proptosis, vision loss and other symptoms.

    B. leukemia signs

    Liver, spleen, lymph nodes which is leukemia common signs of acute lymphoblastic early by approximately 50% in patients with lymph node enlargement, acute non-lymphocytic leukemia in M5 incidence of lymph node enlargement were more common. Enlargement of the liver and spleen can cause loss of appetite, bloating, fatigue, weight loss, etc.. Acute leukemia, acute lymphoblastic significant minority ANLL mild to moderate swelling.

    Signs of nervous system due to chemotherapy drugs is not easy to penetrate the blood-brain barrier, the central nervous system leukemia to become a prominent issue. Leukemia cell infiltration of clinical symptoms, some brain tumor symptoms similar. Infiltration of the meninges, symptoms similar to meningitis, intracranial hypertension, headache, nausea, vomiting, papilledema, visual impairment. Leukemia cells can be found in the cerebrospinal fluid protein is normal or slightly increased. Leukemia cell infiltration cranial nerves, spinal cord, the clinically visible Kouyanwaixie, dizziness, paraplegia, incontinence. More than half of the patients with EEG changes. Serious illness to coma and even death. Central nervous system leukemia can occur in leukemia with active or in remission, especially in children with acute lymphoblastic leukemia can be as high as 36% to 83% of the central nervous system.

    3 signs of acute leukemia in bone and joint tenderness of sternum this diagnosis. Leukemia cell infiltration destruction of cortical bone, bone marrow and joints, joint pain is more common in children, limb bone pain were more common in adult acute lymphocytic leukemia.

    Oral and skin signs of leukemia cells infiltrating the oral mucosa, the performance of the gum swelling or macroglossia, which occurred acute monocytic leukemia and acute tablets. Monocytic leukemia, often accompanied by a secondary infection, bleeding, dry mouth psychosis. Leukemia cell infiltration in the skin, the performance of the rash and lavender small papules, nodules, plaques, and ulcers and other. Biopsy skin imprints diagnostic significance. The performance of the non-specific skin still urticaria, herpes zoster, itching, erythema multiforme.

    5. The cardiopulmonary signs of leukemia cells infiltration of the heart, more common in the pericardium, occasional myocarditis, pericarditis, heart failure performance. It has been reported found serious leukemia more than 60% have pulmonary infiltrates, especially acute tablets – monocytic leukemia more common. The pulmonary infiltrates concurrent infections, tuberculosis, exactly like in the X-ray sometimes pleural effusion. Clinical fever. Cough, cough, chest tightness, shortness of breath.

    6. Gonadal leukemia cell infiltration in the testis, already in the early stages, about 2%. Is outside the central nervous system of a second extramedullary recurrence site. Acute tablets, acute lymphocytic leukemia, lymphoma leukemia period occurred testicular infiltration by 3.7%, 7.4%, and 23.5%, respectively. Testicular infiltration can no obvious symptoms, can be presented with unilateral or bilateral diffuse enlargement, hard, opaque, local puncture or biopsy confirmed individual leukemia patients with priapism may be associated with the intracavernous leukemia cells bolt sub. More common in acute lymphoblastic leukemia. Ovarian leukemia disease is rare.

    7. The green tumor Green tumor common in children and young people with acute myeloid leukemia patients, clinical visible orbital subperiosteal asymmetric exophthalmos, followed see dry temporal bone, nasal bone, sternum, ribs, pelvis, nodular mass, bone marrow cavity, breast, liver, kidney, muscle, may also be involved. Green tumor infiltration at all appeared green, green containing large amounts of myeloperoxidase.

    8 other parts of the gastrointestinal tract: About 25% of patients diagnosed with leukemia when the infiltration of leukemic cells. The clinical symptoms of abdominal pain, diarrhea, gastrointestinal bleeding, such as appendicitis, intestinal obstruction; urinary infiltration of the main symptoms of hematuria, urinary tract infection embolism. Leukemic cell infiltration of the thyroid, pancreas, complicated by diabetes or hypoglycemia embolism.

    Examination: anemia, appearance and tenderness of sternum, liver, spleen, lymph nodes and signs.