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Acute myeloid leukemia with severe coagulation disorder and concomitant central nervous system bleeding - a clinical

S Hatzl1, B Uhl1, M Hinterramskogler2

  • 1Division of Hematology, Department of Internal Medicine, Medical University of Graz, Austria.

EJIFCC
|July 28, 2018
PubMed

We report a case of severe central nervous system bleeding in a patient with acute monocytic leukemia. The patient was admitted to our emergency department because of massive back pain and positive meningeal signs. MR imaging yielded a spontaneous epidural hematoma of the thoracic vertebral column. Coagulation studies revealed fibrinogen levels below the linear measuring range and blood smears showed myeloid blast cells in the peripheral blood. The diagnosis of acute monocytic leukemia was confirmed by flow cytometric analysis. Despite of substitution with more than 12 g fibrinogen per day over 3 days plasma fibrinogen levels couldn't be stabilized. After starting the induction chemotherapy with cytarabine, laboratory coagulation test results were improved. Despite all intensive medical efforts, the patient died due to cerebral epidural hematoma.

Keywords:
acute myeloid leukemiableedingdisseminated intravascular coagulopathy

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