急性早幼粒细胞白血病：胎盘早剥后出现长时间弥散性血管内凝血的罕见病因。

Acute promyelocytic leukemia: an unusual cause showing prolonged disseminated intravascular coagulation after placental abruption.

作者信息

Morimatsu Yukako, Matsubara Shigeki, Hirose Noriko, Ohkuchi Akihide, Izumi Akio, Ozaki Katsutoshi, Ozawa Keiya, Suzuki Mitsuaki

机构信息

Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.

出版信息

Arch Gynecol Obstet. 2008 Mar;277(3):267-70. doi: 10.1007/s00404-007-0444-z. Epub 2007 Aug 23.

DOI:10.1007/s00404-007-0444-z

PMID:17713776

Abstract

BACKGROUND

Disseminated intravascular coagulation (DIC) caused by placental abruption usually improves rapidly after prompt delivery and adequate anti-DIC treatment.

CASE

A 30-year-old nulliparous woman suffered from placental abruption at the 25th week of pregnancy, and emergent cesarean section was done immediately. She exhibited DIC, which continued even after termination of the pregnancy and anti-DIC treatment. She also showed neutropenia. We closely observed her, and at the 58th day postpartum, blast cells appeared in the peripheral blood and she was diagnosed with acute promyelocytic leukemia (APL). Induction chemotherapy was done successfully. The close observation after delivery enabled us to make the prompt diagnosis/treatment, leading to the complete remission.

CONCLUSION

APL should be added to the list of differential diagnosis when DIC persists even after prompt delivery and appropriate anti-DIC treatment after placental abruption.

摘要

背景

胎盘早剥所致的弥散性血管内凝血（DIC）通常在迅速分娩及进行充分的抗DIC治疗后迅速改善。

病例

一名30岁未孕女性在妊娠25周时发生胎盘早剥，随即立即进行了急诊剖宫产。她出现了DIC，即使在终止妊娠及进行抗DIC治疗后仍持续存在。她还表现为中性粒细胞减少。我们对她进行了密切观察，产后第58天，外周血中出现了原始细胞，她被诊断为急性早幼粒细胞白血病（APL）。诱导化疗成功完成。产后的密切观察使我们能够及时做出诊断/治疗，从而实现完全缓解。