Open AccessAcute promyelocytic leukemia presenting as pulmonary thromboembolism: Not all APLs bleed
Author(s) -
Ashok Vaid,
Sandeep Batra,
Suman S Karanth,
Sachin Gupta
Publication year - 2015
Publication title -
avicenna journal of medicine
Language(s) - English
Resource type - Journals
eISSN - 2249-4464
pISSN - 2231-0770
DOI - 10.4103/2231-0770.165125
Subject(s) - medicine , acute promyelocytic leukemia , arsenic trioxide , deep vein , thrombosis , bone marrow , retinoic acid , gastroenterology , apoptosis , biochemistry , chemistry , gene
We present a rare case of acute promyelocytic leukemia (APL) presenting as pulmonary thromboembolism being misdiagnosed as community.acquired pneumonia. Thrombotic phenomenon in APL are poorly understood and grossly underreported. In our case, following no response to standard antibiotic treatment, the patient was further investigated and detected to have an acute pulmonary thromboembolism following right lower limb deep vein thrombosis (DVT). Though, complete blood picture revealed only mild hyperleukocytosis, bone marrow biopsy and aspiration revealed 60% blasts and a positive t (15,17)(q22,12) and PML retinoic acid receptor alpha (RARA) fusion protein on molecular cytogenetics. He was diagnosed as APL and received treatment with all.transretinoic acid (ATRA) and arsenic trioxide (ATO) and therapeutic anticoagulation