Retinoic acid syndrome.
Vitamin A derivative all-transretinoic acid (ATRA) has been reported to improve the outcome in patients with acute promyelocytic leukemia (APL). Retinoic Acid Syndrome (RAS) is a complication that has been noted to occur during the treatment of APL with ATRA. It is a clinical syndrome consisting of a constellation of signs and symptoms. In a patient with APL on ATRA, the diagnosis of RAS can be made based upon the presence of three of the following features: Fever, dyspnea, weight gain, hypotension, renal failure, pulmonary infiltrates, pleural effusion, and pericardial effusion. Pulmonary manifestations, especially pulmonary edema, are the most common presentation. Incidence of this adverse effect ranges from 6% to 27%. The pathogenesis of this complication is not completely understood. It can be potentially life threatening if not promptly recognized and treated. We report a case of retinoic acid syndrome in a young male with APL being treated with ATRA.
Datta
Debapriya
D
Dept of Pulmonary and Critical Care Medicine, St Francis Hospital and Medical Center, 114, Woodland Street, Hartford, CT 06105, USA.
Gerardi
Daniel A
DA
D000328:Adult; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000188:drug therapy*; D008297:Male; D013577:Syndrome; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use
D014212:Tretinoin