How to differentiate acute leukemia from functional uterine bleeding?

Bleeding is one of the main clinical manifestations of acute leukemia. Some patients present with persistent vaginal bleeding as the main complaint, which can be easily misdiagnosed as functional uterine bleeding. This is because acute leukemia presents bleeding, anemia, infection, and infiltration as the main clinical manifestations, but the order and severity of the symptoms vary during the course of the disease. Some patients present with vaginal bleeding as the main complaint, and the symptoms of infection and infiltration are not obvious, so anemia is easily considered as hemorrhagic anemia; or misdiagnosis may be caused by lack of doctor experience or limited testing capabilities.

Therefore, in order to better distinguish functional uterine bleeding from acute leukemia, the doctor must first ask about the medical history in detail and conduct a careful physical examination. The main cause of bleeding in acute leukemia is thrombocytopenia as the pathological basis, so bleeding is more common in the skin and mucous membranes. Patients often have skin bleeding and gingival bleeding. If there is simple functional uterine bleeding, it should not be combined with bleeding of the skin and mucous membranes. In addition, if a careful physical examination is performed, signs of leukemia infiltration such as sternum and sacral tenderness, superficial lymphadenopathy, and hepatosplenomegaly can be found. These are the main signs that distinguish acute leukemia from functional uterine bleeding. Secondly, patients with bleeding and anemia should undergo a routine blood test. Routine blood tests are not only simple and convenient, but also very valuable for diagnosis. Acute leukemia often has low hemoglobin and platelets, and immature cells can be seen in the classification of white blood cells, which cannot be explained by functional uterine bleeding. Once the above abnormalities are found, a bone marrow puncture should be performed to confirm the diagnosis.