[Retinoic acid syndrome. Severe respiratory insufficiency treated with CPAP].
Retinoic acid syndrome is a potentially life-threatening complication of therapy for acute promyelocytic leukemia (APL) with all-transretinoic acid (ATRA). The case of a 55-year old male patient admitted to the hospital because of a bleeding diathesis is reported. APL was diagnosed and he underwent treatment with idarubicin and ATRA (GIMEMA protocol); 24 hrs after ATRA treatment he developed retinoic acid syndrome and was admitted to the Intensive Care Unit because of severe respiratory insufficiency (dyspnoea, tachypnea and severe hypoxemia (SpO2 75%). Pulmonary insufficiency was treated non-invasively with CPAP and the patient recovered from pulmonary distress one week later.
Tommasino
C
C
Cattedra di Anestesiologia e Rianimazione, IRCCS H San Raffaele, Università degli Studi, Milano. tommasino.concezione@hsr.it
De Felice
L
L
Colombo
S
S
Salaris
D
D
Capocasa
T
T
Giudici
D
D
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000188:drug therapy; D008297:Male; D011859:Radiography; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy*; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014212:Tretinoin