A case of all-trans retinoic acid-induced myositis in the treatment of acute promyelocytic leukaemia.
The use of all-trans retinoic acid (ATRA) is now standard therapy for the treatment of acute promyelocytic leukaemia (APML). There have been increasing reports of ATRA-induced myositis, with its frequent association with retinoic acid syndrome and Sweet's syndrome. We report a case of a young man with APML who developed ATRA-induced myositis characterized by unexplained fevers, bilateral leg swelling and a non-painful purpuric, petechial rash, with prompt resolution of symptoms and signs with high-dose steroids and cessation of ATRA. Rapid recognition of this adverse reaction and prompt institution of steroids is of prime importance given its potentially fatal course.
Chan
K H
KH
Division of Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia. kimhoe_chan@yahoo.com.au
Yuen
S L S
SL
Joshua
D
D
D000328:Adult; D005076:Exanthema; D005334:Fever; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009220:Myositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D013256:Steroids / Q000627:therapeutic use; D014212:Tretinoin / Q000009:adverse effects*
D013256:Steroids; D014212:Tretinoin