[全反式维甲酸综合征。病例报告及文献综述]

[All-trans retinoic acid syndrome. Case report and a review of the literature].

作者信息

Carrillo-Esper Raúl, Carvajal-Ramos Roberto, Contreras-Domínguez Vladimir, Hernández-Aguilar César, Romano-Estrada Lorena, Melo-Martínez Carlos

机构信息

Servicio de terapia intensiva, HCSAE PEMEX.

出版信息

Gac Med Mex. 2004 Sep-Oct;140(5):547-52.

PMID:15559237

Abstract

We described a patient with acute promyelocytic leukemia (APL) who developed all-trans retinoic acid syndrome (ATRAS) and reviewed the literature. ATRAS presents in patients with APL treated with all-trans retinoic acid (ATRA). It has an incidence from 5%-27% with mortality of 29%. It is secondary to ATRA effect on promyelocyte differentiation, which causes systemic inflammatory response syndrome, endothelium damage with increase in capillary permeability, microcirculation obstruction, and tissue infiltration. ATRAS clinical manifestations are fever, hypotension, respiratory, renal and hepatic insufficiency, lung infiltrates, pleural and pericardic effusion, and generalized edema. Treatment is based on ATRA suspension, support measures, and steroids.

摘要

我们描述了一名患有急性早幼粒细胞白血病（APL）并发生全反式维甲酸综合征（ATRAS）的患者，并对相关文献进行了综述。ATRAS发生于接受全反式维甲酸（ATRA）治疗的APL患者中。其发病率为5% - 27%，死亡率为29%。它继发于ATRA对早幼粒细胞分化的影响，这会导致全身炎症反应综合征、内皮损伤伴毛细血管通透性增加、微循环障碍及组织浸润。ATRAS的临床表现为发热、低血压、呼吸、肾脏及肝脏功能不全、肺部浸润、胸腔及心包积液以及全身性水肿。治疗基于停用ATRA、支持措施及使用类固醇。