Evidence map›Paper›PMID 38406084›Full record

ArticleCureus2024

Blueberry Muffin Syndrome and Hyperleukocytosis in a Newborn: A Diagnostic Challenge.

Beatriz Teixeira, Ana Losa, Andreia Meireles, Ana Lachado, Isabel Couto Guerra, Susana Machado, Lídia Branco, Paulo Paulino, Catarina Lau, Natália Oliva-Teles and 5 more

Open access · diamondAbstract readCase Reports
In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 1 country.

Beatriz TeixeiraPediatrics Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Ana LosaPediatrics Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Andreia MeirelesNeonatology Unit, Centro Hospitalar Tâmega e Sousa, Penafiel, PRT.
Ana LachadoPediatric Hematology Unit, Pediatrics Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Isabel Couto GuerraPediatric Hematology Unit, Pediatrics Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Susana MachadoDermatology Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Lídia BrancoImmunology Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Paulo PaulinoLaboratorial Hematology Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Catarina LauClinical Hematology Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Natália Oliva-TelesCytogenetics Unit, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Carlos MendesLaboratorial Hematology Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, PRT.
Tereza OlivaPediatric Department, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, PRT.
Liliana PinhoNeonatology Intensive Care Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Luísa NeivaNeonatology Intensive Care Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Elisa ProençaNeonatology Intensive Care Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Centro Hospitalar do Porto · PTHospital de Santo António · PTIPO Porto · PTCentro de Genética Clínica · PTCentro Hospitalar do Tâmega e Sousa · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Blueberry muffin syndrome (BMS) in neonates, characterized by widespread nodular lesions, presents diagnostic challenges due to its diverse etiologies. Hyperleukocytosis, with leukocyte counts exceeding 100,000/μL, is a rare phenomenon associated with severe complications in neonates. Congenital leukemia (CL), a rare diagnosis within the first month of life, is linked to high mortality. This case report presents a unique case of BMS with hyperleukocytosis as the initial presentation of CL. A full-term male newborn, born after an uncomplicated pregnancy, except for Kell isoimmunization, with an Apgar score of 9/10, and an irrelevant family history, showed widespread purple nodules consistent with BMS at birth. Laboratory workup revealed mild anemia, hyperleukocytosis with immature granulocytes on peripheral blood (PB) smear, positive direct antiglobulin test, and elevated alanine aminotransferase and lactate dehydrogenase, without hyperbilirubinemia. Empirical antibiotics and hyperhydration were started, and the neonate was transferred to a level 3 neonatal intensive care unit for further evaluation. A comprehensive etiological investigation was conducted, comprising infectious, immunological, metabolic, and neoplastic factors. A skin nodule biopsy revealed an infiltrate of blast cells, indicative of leukemia cutis, and a bone marrow aspirate confirmed acute myeloid leukemia (AML). The patient successfully completed the NOPHO-DBH-2012 chemotherapy protocol at five months and remains in complete remission at nine months. This case report contributes to the literature by highlighting the diagnostic approach and management strategies for CL presenting with BMS and hyperleukocytosis. This case aims to enhance awareness and understanding of BMS as an initial manifestation of CL. Additionally, the challenges of treating leukemia in neonates, coupled with the lack of specific guidelines for this age group, further underscore the complexities in managing such patients.

Indexed as

acute myeloid leukemiablueberry muffin syndromecongenital leukemiacytogenetic analysishyperleukocytosis

Identifiers

PMID38406084
PMCPMC10884724
OpenAlexW4391164603

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.