title: Undiagnosed, untreated acute promyelocytic leukemia presenting as a suspicious sudden death.
abstract: Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia frequently associated with clotting abnormalities and severe hemorrhagic diathesis. The disease is associated with a high incidence of early fatal hemorrhage. We report the sudden death of a 40-year-old male without significant medical history in which foul play had been initially suspected. A thorough postmortem investigation performed on the decedent lead to the diagnosis of APL. Cause of death was a cerebellar hematoma. Underlying APL should be considered in the differential diagnosis when unexplained bleeding is encountered in a decedent. This case emphasizes the value of routinely collecting bone marrow during an autopsy to enable accurate testing and diagnosis.
authors.affiliation: Service de Médecine Légale, Université François Rabelais, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France. p.saint-martin@chu-tours.fr
authors.forename: Pauline
authors.initials: P
authors.lastname: Saint-Martin
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Byrne
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaulier
authors.forename: Sophie
authors.initials: S
authors.lastname: Martin-Dupont
authors.forename: Agnès
authors.initials: A
authors.lastname: Peyclit
authors.forename: François
authors.initials: F
authors.lastname: Paraf
mesh_terms: D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D002526:Cerebellar Diseases / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000473:pathology; D003288:Contusions / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology*; D049429:Forensic Pathology; D006406:Hematoma / Q000473:pathology; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis*; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000473:pathology