Acute Promyelocytic Leukemia Developed in a Patient with Systemic Lupus Erythematosus.
- Author:
Jin Hyuk YANG
1
;
Sung Ran CHO
;
Bong Hak HYUN
;
Young Ae LIM
;
Wee Gyo LEE
Author Information
1. Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea. sungran@madang.ajou.ac.kr
- Publication Type:Case Report
- Keywords:
Systemic lupus erythematosus;
G-CSF;
Bronchoalveolar lavage;
Acute promyelocytic leukemia
- MeSH:
Bone Marrow;
Bronchoalveolar Lavage;
Diagnosis;
Disseminated Intravascular Coagulation;
Dizziness;
Female;
Fever;
Granulocyte Colony-Stimulating Factor;
Granulocyte Precursor Cells;
Hemorrhage;
Humans;
Leukemia, Promyelocytic, Acute*;
Lupus Erythematosus, Systemic*;
Myeloid Cells;
Neutropenia;
Pancytopenia;
Sepsis;
Shock, Septic;
Young Adult
- From:The Korean Journal of Laboratory Medicine
2002;22(4):232-235
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 19-year-old, woman who had been diagnosed as systemic lupus erythematosus (SLE) a year ago, was admitted because of fever, dizziness, and sustained postoperative bleeding after a hemorroidectomy. On admission, a CBC revealed pancytopenia (Hb 6.2 g/dL, WBC 1,200/microL, platelets 11,000/microL) with a shift to themicroLeft, and the FDP and D-dimer were positive. She was treated for sepsis and disseminated intravascular coagulation. Granulocyte colony-stimulating factor (G-CSF) was administrated twice for severe neutropenia. An increase in WBC and immature myeloid cells, mainly hypergranular promyelocytes on the peripheral blood followed and was considered to be the effect of G-CSF. To evaluate the cause of pulmonary infiltrates, bronchoalveolar lavage (BAL) was performed on the 5th day of admission. The BAL fluid revealed many promyelocytes and myelocytes with occasional structures recognized as Auer rods. Acute promyelocytic leukemia (APL) was confirmed on the bone marrow study and chromosome analysis. Unfortunately, the patient died of septic shock on the 9th day of admission. We report here a very rare case of APL diagnosed in a SLE patient, the diagnosis of which was somewhat delayed due to the use of G-CSF and superimposed sepsis.
