Is shaking a symptom of leukemia? I have a 4 yr old child in my daycare, she had a bladder infection,  and something was not right with her blood work, so they did further testing and  found a mass on her kidney, further testing showed she was fine. I noticed a  massive nose bleed and she has never had one before, and she could barely color  one day she was shaking so bad. She is the one who brought up the shaking before  I noticed. She does complain of headaches, back aches, and an occasional cough accompanied with a clear runny nose. We just thought it was allergies. Is this anything to be concerned about?

Dear Ms Connolly,

Thank you for your question concerning the possible signs and symptoms of leukemia in a child. The symptoms that you described can have many causes and may or may not all be related. Here are the most common signs and symptoms associated with leukemia: anemia, fatigue/malaise, easy bruising/bleeding,recurrent infections, bone pain, swelling of the face/extremities/gums, swollenlymph nodes, loss of appetite/weight loss, coughing, or headaches/seizures/vomiting.

What raises suspicion if you are dealing with a more serious problem is how these symptoms present themselves. If leukemia is suspected, it needs to be diagnosed by specific battery of tests.Many children with allergies will have cough, clear runny nose, and occasional headaches.

Nosebleeds can be associated with certain infections (strep),allergies, use of certain medications, dry air, exposed blood vessels, and trauma. Urinary tract infections can happen to young girls who may not be wiping properly. What are interesting are the kidney “mass” and the shaking. The shaking episode is something that the parents should know about, if they don’t know already.

It could have many be nign causes but deserves investigation, especially if it happens many times. Also, it seems the child has undergone some level of testing already due to the bladder infection. When caring for other people’s children, it is important to communicate as much as possible to the parents about any potential problem you witness.

Sometimes a small or minor symptom may point to a bigger problem. The best course of action is to let the parents know your concerns about the child. Although leukemia is one of the more common forms of childhood cancers, it still is relatively rare. A visit to the pediatrician will help sort out any concerns and help identify most of the causes of the various signs and symptoms.

Hopefully this helps to answer your question.
Dr. Bill