Back issues No.2 - 2011 / Case Report  

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Blueberry muffin baby with acute myeloid leukemia and spontaneous remission
Ya-Wen Hsiao , Fang-Wen Tseng , Yi-Ling Shih , Tseng-tong Kuo , Tang-Her Jaing , Rosaline Chung-Yee Hui

Blueberry muffin baby is a rare neonatal skin disorder. Causes for the generalized hemorrhagic purpuric
eruptions include congenital infections, hemolysis, and tumors.We report a 2.5-month-old female baby with
a blueberry muffin appearance, respiratory distress, and decreased activity and appetite. Skin biopsy showed
diffuse infiltrates of myeloperoxidase- and lysozyme-positive blast-like cells in dermis and superficial
subcutis. Bone marrowstudy confirmed the diagnosis of acute monocytic leukemia with leukemia cutis. The
skinnodules regressed spontaneously without chemotherapy over several days,andthe peripheral blood cell
counts normalized. This spontaneous remission lasted for 2 months. Spontaneous remission of infantile
leukemia is rare, and its mechanism remains unknown. Although overt leukemia relapsed in some of these
patients, a delay in chemotherapy spared these infants of the toxic effects of treatment.

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