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Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage

Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially in the acute promyelocytic leukemia subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis...

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Autores principales: Wu, Meng-Yu, Lin, Ching-Hsiang, Hou, Yueh-Tseng, Lin, Po-Chen, Yiang, Giou-Teng, Tien, Yueh-Cheng, Yeh, Hsiao-Ching
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721397/
https://www.ncbi.nlm.nih.gov/pubmed/31434194
http://dx.doi.org/10.3390/brainsci9080207
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author Wu, Meng-Yu
Lin, Ching-Hsiang
Hou, Yueh-Tseng
Lin, Po-Chen
Yiang, Giou-Teng
Tien, Yueh-Cheng
Yeh, Hsiao-Ching
author_facet Wu, Meng-Yu
Lin, Ching-Hsiang
Hou, Yueh-Tseng
Lin, Po-Chen
Yiang, Giou-Teng
Tien, Yueh-Cheng
Yeh, Hsiao-Ching
author_sort Wu, Meng-Yu
collection PubMed
description Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially in the acute promyelocytic leukemia subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis is also triggered via release of annexin II, t-PA, u-PA, and u-PAR. Various inflammatory cytokines from cancer cells, such as IL-1β and TNF-α, activate endothelial cells and promote leukostasis. This condition may increase the ICH risk and lead to poor clinical outcomes. Here, we present a case under a unique situation with acute ICH detected prior to the diagnosis of AML. The patient initially presented with two episodes of syncope. Rapidly progressive ICH was noted in follow-up computed tomography (CT) scans. Therefore, we highlight that AML should be among the differential diagnoses of the etiologies of ICH. Early diagnosis and timely intervention are very important for AML patients.
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spelling pubmed-67213972019-09-10 Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage Wu, Meng-Yu Lin, Ching-Hsiang Hou, Yueh-Tseng Lin, Po-Chen Yiang, Giou-Teng Tien, Yueh-Cheng Yeh, Hsiao-Ching Brain Sci Case Report Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially in the acute promyelocytic leukemia subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis is also triggered via release of annexin II, t-PA, u-PA, and u-PAR. Various inflammatory cytokines from cancer cells, such as IL-1β and TNF-α, activate endothelial cells and promote leukostasis. This condition may increase the ICH risk and lead to poor clinical outcomes. Here, we present a case under a unique situation with acute ICH detected prior to the diagnosis of AML. The patient initially presented with two episodes of syncope. Rapidly progressive ICH was noted in follow-up computed tomography (CT) scans. Therefore, we highlight that AML should be among the differential diagnoses of the etiologies of ICH. Early diagnosis and timely intervention are very important for AML patients. MDPI 2019-08-20 /pmc/articles/PMC6721397/ /pubmed/31434194 http://dx.doi.org/10.3390/brainsci9080207 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Wu, Meng-Yu
Lin, Ching-Hsiang
Hou, Yueh-Tseng
Lin, Po-Chen
Yiang, Giou-Teng
Tien, Yueh-Cheng
Yeh, Hsiao-Ching
Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title_full Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title_fullStr Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title_full_unstemmed Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title_short Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage
title_sort syncope as initial presentation in an undifferentiated type acute myeloid leukemia patient with acute intracranial hemorrhage
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721397/
https://www.ncbi.nlm.nih.gov/pubmed/31434194
http://dx.doi.org/10.3390/brainsci9080207
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