A Case of Subacute Brain Hemorrhage and Disseminated Intravascular Coagulation Secondary to Acute Promyelocytic Leukemia in a Pediatric Patient.
Cureus
; 13(5): e14922, 2021 May 09.
Article
in English
| MEDLINE | ID: covidwho-1239163
ABSTRACT
Acute promyelocytic leukemia (APML), characterized by the reciprocal translocation between chromosomes 15 and 17 [t(15;17)], is a result of proliferation of myeloid cells maturation which is interrupted at the promyelocytic stage. The central, and the most important, distinguishing feature of APML is a predisposition to disseminated intravascular coagulation (DIC). The overall prognosis of APML is very good, with 90% of patients achieving complete remission. We find it important to remind pediatric practitioners, both in the ambulatory and urgent care room settings, of presenting signs and symptoms of leukemia, as well as, up-to-date on management of such fulminant scenarios as DIC. Intracranial hemorrhage (ICH) is one of the commonest, and frequently fulminant complication of APML seen after initiation of induction chemotherapy. We report on a young female presenting with non-specific upper respiratory illness symptoms and recurrent headache, who was found to already have ICH and to be in DIC in the setting of APML at the time of initial evaluation. This case illustrates importance of thorough assessment and prompt consideration of wide differential diagnosis, which became somewhat limited and biased towards web-based telemedicine in the COVID-19 pandemics era.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Diagnostic study
/
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Cureus
Year:
2021
Document Type:
Article
Affiliation country:
Cureus.14922
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