An Unusual Presentation of T-Cell Acute Lymphoblastic Leukemia: Syncope and Hypercalcemia of Malignancy

Abstract

Introduction: Hypercalcemia is an exceedingly rare presentation of T-cell acute lymphoblastic leukemia (ALL) in children. While often varied and nonspecific, the clinical manifestations of hypercalcemia can provide a clue to severe underlying disease, making prompt diagnosis imperative. Case Description: A previously healthy 14-year-old girl presented to the emergency department after multiple witnessed syncopal episodes. The events were preceded by dizziness and lasted approximately 10-15 seconds. She had no associated abnormal movements, incontinence, or subsequent confusion. Review of systems revealed one episode of emesis; left rib pain, polyuria, and polydipsia for …