Acute leukemia manifesting as a pericardial effusion in a pregnant female: A rare event

Pregnancy is an immunocompromised and hyperdynamic state. Although pregnancy makes a female vulnerable to a plethora of infections, primary malignancies in pregnancy constitute only about 0.1% of all malignant cases, out of which acute leukemias are relatively rare. Here, we present a case of acute leukemia presenting for the 1 st time in pregnancy with the unusual manifestation of pericardial effusion. A 32-year-old patient, G3P2L2, presented to the obstetrics outpatient department of our hospital at 27 weeks with low-grade fever and dyspnea. Apart from other obstetric complications, radiological investigations confirmed pericardial effusion. Initial complete blood count revealed a markedly increased total leucocyte count of 88.9 × 10 3 /mm 3 . Percutaneous pericardial drainage and peripheral blood film examination revealed a predominance of immature cells resembling blasts in both fluids. Pre-pregnant hematological records did not show any such abnormality. Chemotherapy was immediately commenced. However, the patient succumbed to acute leukemia. Due to its vague and nonspecific symptoms, the diagnosis of acute leukemia often poses an immense diagnostic dilemma, especially in early pregnancy. Even if diagnosed, chemotherapy needs to be administered with utmost precision to minimize adverse effects to the mother and fetus. Cases such as these need to be given due attention to consider leukemia as a possibility during pregnancy.