All-trans retinoic acid-induced focal myositis, synovitis, and mononeuritis.
All-trans retinoic acid has revolutionized the treatment of acute promyelocytic leukemia, but this therapy is often complicated by the all-trans retinoic acid syndrome. Here we report a patient with newly diagnosed acute promyelocytic leukemia who developed acute focal myositis, synovitis, and possible vasculitis, after receiving all-trans retinoic acid therapy. We review the existing literature on this rare clinical entity, all-trans retinoic acid-induced myositis. This condition can manifest as fever, myalgia, arthralgia, and Sweet syndrome, accompanied by distinct magnetic resonance findings involving the lower extremity musculature. Treatment consists of discontinuation of the offending drug and often high dose corticosteroids.
Yu
Wenshu
W
Department of Medicine, Division of Rheumatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
Burns
Christopher M
CM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy; D008875:Middle Aged; D020422:Mononeuropathies / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D009220:Myositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D013585:Synovitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D028761:Withholding Treatment
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D014212:Tretinoin