[All-trans retinoic acid syndrome. Case report and a review of the literature].
We described a patient with acute promyelocytic leukemia (APL) who developed all-trans retinoic acid syndrome (ATRAS) and reviewed the literature. ATRAS presents in patients with APL treated with all-trans retinoic acid (ATRA). It has an incidence from 5%-27% with mortality of 29%. It is secondary to ATRA effect on promyelocyte differentiation, which causes systemic inflammatory response syndrome, endothelium damage with increase in capillary permeability, microcirculation obstruction, and tissue infiltration. ATRAS clinical manifestations are fever, hypotension, respiratory, renal and hepatic insufficiency, lung infiltrates, pleural and pericardic effusion, and generalized edema. Treatment is based on ATRA suspension, support measures, and steroids.
Carrillo-Esper
Raúl
R
Servicio de terapia intensiva, HCSAE PEMEX. seconcapcma@mail.medinet.net.mx
Carvajal-Ramos
Roberto
R
Contreras-Domínguez
Vladimir
V
Hernández-Aguilar
César
C
Romano-Estrada
Lorena
L
Melo-Martínez
Carlos
C
D000328:Adult; D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D017093:Liver Failure / Q000139:chemically induced; D051437:Renal Insufficiency / Q000139:chemically induced; D012131:Respiratory Insufficiency / Q000139:chemically induced; D013577:Syndrome; D014212:Tretinoin / Q000009:adverse effects*
D000970:Antineoplastic Agents; D014212:Tretinoin