Acute promyelocytic leukemia: an unusual cause showing prolonged disseminated intravascular coagulation after placental abruption.
BACKGROUND
Disseminated intravascular coagulation (DIC) caused by placental abruption usually improves rapidly after prompt delivery and adequate anti-DIC treatment.


METHODS
A 30-year-old nulliparous woman suffered from placental abruption at the 25th week of pregnancy, and emergent cesarean section was done immediately. She exhibited DIC, which continued even after termination of the pregnancy and anti-DIC treatment. She also showed neutropenia. We closely observed her, and at the 58th day postpartum, blast cells appeared in the peripheral blood and she was diagnosed with acute promyelocytic leukemia (APL). Induction chemotherapy was done successfully. The close observation after delivery enabled us to make the prompt diagnosis/treatment, leading to the complete remission.


CONCLUSIONS
APL should be added to the list of differential diagnosis when DIC persists even after prompt delivery and appropriate anti-DIC treatment after placental abruption.
Morimatsu
Yukako
Y
Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.
Matsubara
Shigeki
S
Hirose
Noriko
N
Ohkuchi
Akihide
A
Izumi
Akio
A
Ozaki
Katsutoshi
K
Ozawa
Keiya
K
Suzuki
Mitsuaki
M
D000037:Abruptio Placentae / Q000209:etiology* / Q000601:surgery; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000188:drug therapy; D009503:Neutropenia / Q000209:etiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000188:drug therapy
D000970:Antineoplastic Agents