Suzuki Daisuke, Kikuchi Kenji, Sugasawa Kunie, Saito Soichi, Suzuki Yoshihiro
Neurology, Nihonkai General Hospital, Sakata, JPN.
Hematology, Nihonkai General Hospital, Sakata, JPN.
Cureus. 2024 Sep 30;16(9):e70563. doi: 10.7759/cureus.70563. eCollection 2024 Sep.
There are neither predictive tests nor preventive strategies/treatments for acute promyelocytic leukemia (APL)-associated bleeding/thrombosis incidence. We encountered the case of a woman in her 70s who was admitted due to sudden-onset right hemiparesis. The patient was diagnosed with acute cerebral infarction as the initial manifestation of APL. Intravenous recombinant human soluble thrombomodulin was initiated on admission, followed by oral all-trans retinoic acid two days later. However, the patient's condition deteriorated due to APL-associated diphasic cerebral infarction with left internal carotid artery occlusion, and she died 10 days after admission. Thus, the degree of main artery stenosis should be evaluated before treatment in patients with APL who have coagulopathy.
对于急性早幼粒细胞白血病（APL）相关的出血/血栓形成发生率，既没有预测性检测方法，也没有预防性策略/治疗手段。我们遇到了一位70多岁的女性患者，她因突发右侧偏瘫入院。该患者被诊断为以急性脑梗死作为APL的初始表现。入院时开始静脉注射重组人可溶性血栓调节蛋白，两天后开始口服全反式维甲酸。然而，患者因APL相关的双相性脑梗死伴左颈内动脉闭塞，病情恶化，入院10天后死亡。因此，对于有凝血功能障碍的APL患者，在治疗前应评估主动脉狭窄程度。
