title: Acute respiratory distress syndrome caused by leukemic infiltration of the lung.
abstract: Respiratory distress syndrome resulting from leukemic pulmonary infiltrates is seldom diagnosed antemortem. Two 60- and 80-year-old women presented with general malaise, progressive shortness of breath, and hyperleukocytosis, which progressed to acute respiratory distress syndrome (ARDS) after admission. Acute leukemia with pulmonary infection was initially diagnosed, but subsequent examinations including open lung biopsy revealed leukemic pulmonary infiltrates without infection. In one case, the clinical condition and chest radiography improved initially after combination therapy with chemotherapy for leukemia and aggressive pulmonary support. However, new pulmonary infiltration on chest radiography and hypoxemia recurred, which was consistent with acute lysis pneumopathy. Despite aggressive treatment, both patients died due to rapidly deteriorating condition. Leukemic pulmonary involvement should be considered in acute leukemia patients with non-infectious diffusive lung infiltration, especially in acute leukemia with a high blast count.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Buddhist Tzu Chi General Hospital, Taipei, Taiwan.
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Wu
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Huang
authors.forename: Shiu-Feng
authors.initials: SF
authors.lastname: Huang
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Huang
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017254:Leukemic Infiltration / Q000150:complications*; D008168:Lung / Q000473:pathology*; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000209:etiology*