NMC Royal Hospital Sharjah Diagnoses Childhood Leukemia Through Sharp Clinical Vigilance
In a compelling case that underscores the life-saving power of early diagnosis and expert collaboration, doctors at NMC Royal Hospital Sharjah identified and confirmed a rare and aggressive form of childhood blood cancer—B-lymphoblastic leukemia (B-ALL)—in a previously healthy 10-year-old boy, thanks to an unwavering commitment to clinical vigilance and multidisciplinary teamwork.
The child had initially presented with persistent fever and thrombocytopenia, symptoms easily mistaken for common infections. His journey began at NMC Al Nahda Hospital, where he was referred to Dr. Gaurav Jadon, Consultant Paediatrician at NMC Specialty Hospital, Dubai. A peripheral blood smear, reviewed by Dr. Deepa Madhavan, Specialist in Clinical Pathology, raised red flags that warranted immediate escalation.
He was transferred to NMC Royal Hospital Sharjah for further investigation under the care of Dr. Arwa El Dhuwaib, Specialist Paediatric Hematology and Oncology. A second expert review by Dr. Sherin Mohamed, Consultant in Clinical Pathology and Haematology, confirmed the presence of blast cells, prompting a timely bone marrow biopsy and advanced flow cytometry.
The results were conclusive: the child had B-ALL, a form of leukemia that often escapes early detection due to its subtle onset and lack of typical symptoms such as elevated white blood cell counts.
“This case was a diagnostic puzzle, where every small clue mattered,” said Dr. Arwa El Dhuwaib. “Without the sharp eye of our lab team and the decision to escalate quickly, the diagnosis could have been dangerously delayed.”
Laboratory findings included severe inflammation (CRP > 250 mg/L), high D-Dimer levels (10,800 ng/mL), and a peripheral smear showing 7% atypical immature cells. Despite a normal WBC count, the team noticed key hematologic anomalies—signs of leukemia that could easily be overlooked.
Flow cytometry revealed 35.3% blast cells, with immunophenotyping confirming B-lineage markers. The child was promptly referred for oncology management, offering him the best chance for recovery.
This case is a reminder of how easily pediatric leukemia can masquerade as a routine infection—and how experience, teamwork, and clinical intuition can make the difference between early treatment and life-threatening delay.
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