ACUTE LYMPHOBLASTIC LEUKEMIA ASSOCIATED WITH CORONAVIRAL INTERSTITIAL PNEUMONITIS

ACUTE LYMPHOBLASTIC LEUKEMIA ASSOCIATED WITH CORONAVIRAL INTERSTITIAL PNEUMONITIS

Purpose of the study. To demonstrate one of the clinical cases of acute lymphoblastic leukemia (ALL) associated with acute coronavirus interstitial pneumonitis (AIP).

Materials and methods. A 43-year-old female patient with ALL associated with acute coronavirus interstitial pneumonitis (AIP) was examined.

Results. ALL associated with AIP with a coronavirus etiology was accompanied by hyperthermia, dry cough, breathlessness, anosmia and taste, progressive weakness, severe headache, palpitations, pain in the long bones, bleeding from the gums, abdominal pain, nausea, vomiting and diarrhea, malaise. In the peripheral blood of these categories of persons, lymphocytopenia was found, an increase in the amount of D-dimer to 5 times, ferritin to 6 times, CRP concentration to 3 times. There was a decrease in the degree of blood ventilation (saturation) O2 - 91% up to acute respiratory failure. Thrombotic complications were indirectly manifested in the form of severe shortness of breath, cyanosis of the skin, pain in the heart area and in the lumbar region, and urinary disorders. EchoCG revealed impaired right ventricular function, signs of acute pulmonary hypertension, tricuspid regurgitation, signs of cardiomegaly, possibly associated with acute myocarditis. Computed tomography of the lungs revealed areas of reduced transparency of the parenchyma by the type of “glass opacity”. There was a decrease in the degree of blood ventilation (saturation) O2-83% up to acute respiratory failure.

Conclusions. In a female patient with a severe course of coronavirus infection with a burdened somatic history, an increase in D-dimer and ferritin was observed due to the development of a "cytokine storm". The appearance of signs of overload of the right ventricle, revealed during echocardiography in a patient and a drop in blood pressure, can be considered a sufficient basis for the diagnosis of pulmonary embolism and thrombolysis. Early detection and timely prevention of clinical manifestations of thrombotic complications prevents severe complications and mortality.

Key words: acute lymphoblastic leukemia, acute interstitial coronavirus pneumonitis, cytokine storm, D-dimer, ferritin, saturation.

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Mustafakulova N.I., Rakhmatov M.K., Makhmadaliev F.N., Kholova Sh.K.

Department of Internal Medicine №3


11.01.2021 625