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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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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. |
format | Online Article Text |
id | pubmed-6721397 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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