'Tell me about your pain': abdominal pain and a history of bullying.

Paola Rosati, Alessandro Jenkner, Rita De Vito, Renata Boldrini, Patrizia Chiodi, Lucia Celesti, Rosaria Giampaolo

Research output: Contribution to journalArticle

Abstract

A 7-year-old girl was brought to our outpatient clinic to investigate recurrent abdominal pain. She was unwilling to attend the school. Her mother reported bullying at school and nosebleeds. The girl rated her pain 9 on a visual analogue score card ranging from 1 to 10. Physical examination disclosed painful bruising and haematomas. Emergency laboratory blood tests indicated by the history, physical examination and the pain intensity showed reduced numbers of white blood cells and platelets. A bone marrow smear on admission disclosed 100% blasts and suggested an initial diagnosis of leukaemia but also disclosed the pseudo-rosettes typically seen in neuro-ectodermic tumours. The diagnosis of stage IV primary neuroblastoma was confirmed by trephine biopsies and high urinary catecholamines. The girl died 10 months later. This unusual case underlines the need for outpatient paediatricians to involve children in their initial diagnostic work-up by asking them about their pain thus expediting the diagnosis.

Original languageEnglish
JournalBMJ Case Reports
Volume2011
Publication statusPublished - 2011

Fingerprint

Bullying
Abdominal Pain
Pain
Physical Examination
Epistaxis
Hematologic Tests
Ambulatory Care Facilities
Neuroblastoma
Platelet Count
Hematoma
Catecholamines
Leukemia
Emergencies
Leukocytes
Outpatients
Bone Marrow
History
Mothers
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

'Tell me about your pain' : abdominal pain and a history of bullying. / Rosati, Paola; Jenkner, Alessandro; De Vito, Rita; Boldrini, Renata; Chiodi, Patrizia; Celesti, Lucia; Giampaolo, Rosaria.

In: BMJ Case Reports, Vol. 2011, 2011.

Research output: Contribution to journalArticle

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