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急性早幼粒细胞白血病诱导治疗期间伴严重腹痛的分化综合征:一例报告

Differentiation Syndrome with Severe Abdominal Pain During Induction Treatment of Acute Promyelocytic Leukemia: A Case Report.

作者信息

Yan Haimeng, He Donghua, Huang Weijia, Chen Fei, He Jingsong, Cai Zhen, Zhao Yi

机构信息

Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

Department of Hematology, Haining People's Hospital, Haining, People's Republic of China.

出版信息

J Pain Res. 2021 Jun 30;14:1981-1984. doi: 10.2147/JPR.S305192. eCollection 2021.

Abstract

BACKGROUND

Acute promyelocytic leukemia differentiation syndrome (APL DS) is a common and severe complication seen in patients with APL treated with all-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO). The presenting symptoms of APL DS are diverse, and rare symptoms are easy to be misdiagnosed. Therefore, it is very crucial to identify DS from uncommon signs to avoid delay in treatment.

CASE PRESENTATION

Here, we report a patient of APL who developed severe abdominal pain during ATRA and ATO therapy, with increasing leukocyte count. Organic diseases were firstly excluded, and empiric treatment for DS was adopted. The abdominal pain was gradually relieved and the patient eventually achieved complete remission.

CONCLUSION

This case history suggests that APL DS may manifest as severe abdominal pain, and the early identification of DS and immediate treatment could improve the prognosis of patients.

摘要

背景

急性早幼粒细胞白血病分化综合征(APL DS)是接受全反式维甲酸(ATRA)和/或三氧化二砷(ATO)治疗的APL患者中常见且严重的并发症。APL DS的表现症状多样,罕见症状易被误诊。因此,从非典型症状中识别出DS以避免治疗延误至关重要。

病例报告

在此,我们报告1例APL患者,在接受ATRA和ATO治疗期间出现严重腹痛,白细胞计数升高。首先排除器质性疾病,随后采用DS的经验性治疗。腹痛逐渐缓解,患者最终实现完全缓解。

结论

该病例表明APL DS可能表现为严重腹痛,早期识别DS并立即治疗可改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/231b/8256376/70bdc61fe534/JPR-14-1981-g0001.jpg

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