A case of ischemic stroke in acute promyelocytic leukemia at initial presentation. Relevance of all-trans retinoic acid treatment.
Acute promyelocytic leukemia (APL) is frequently associated, often from the earliest phases, with a life-threatening coagulation/bleeding syndrome; disseminated intravascular coagulation (DIC) is described in majority of patients. We report a case of 49-year-old male, without cardiovascular risk factors, who suddenly developed ischemic stroke and splenic infarction as presenting symptoms of APL and related DIC. The patient was immediately treated with all-trans retinoic acid (ATRA) and the alterations of hemocoagulation parameters promptly returned in normal range. The coagulation/bleeding syndrome of the onset of APL is associated with high mortality; both diagnostic and therapeutic approaches require special and timely consideration of this condition. Treatment with ATRA is essential.
Carella
Angelo M
AM
Internal Medicine Department of T. Masselli-Mascia Hospital - San Severo (Fg), Italy. mic.carella@virgilio.it
Antonucci
Giuseppe
G
Conte
Matteo
M
Di Pumpo
Michele
M
Antonucci
Elisabetta
E
Ponziano
Ernestina
E
D000970:Antineoplastic Agents / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D014212:Tretinoin / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D014212:Tretinoin