A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report

Authors

  • Ismy Azizah Sisnawati Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Kezia Salay Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Listiana Nur Fadillah Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Indi Jazilah Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Jessica Amelinda Mintarjo Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Atiyatum Billah Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia
  • Agung Sunarko Putra Department of Obstetrics and Gynecology, Dr. Ramelan Navy Hospital, Surabaya, Indonesia
  • I Dewa Made Widi Hersana Department of Internal Medicine, Dr. Ramelan Navy Hospital, Surabaya, Indonesia
  • Citra Novita Department of Clinical Pathology, Dr. Ramelan Navy Hospital, Surabaya, Indonesia

Keywords:

Acute promyelocytic leukemia, pregnancy

Abstract

Incidents of leukemia in pregnancy are infrequent with only one case found from 75,000 to 100,000 pregnancies. The pathophysiological mechanism of leukemia during pregnancy is still unclear. Leukemia which occurs in pregnancy is usually acute and predominantly the myeloid type.A 35-year-old woman in her fourth pregnancy with a gestational age of 38-39 weeks, came to the emergency department (ED) with complaints of contractions since 4.5 hours before admission. The contraction was not accompanied by discharge, mucus, or blood, and fetal movements was still active. She denied complaints of fever, nausea, vomiting, dizziness, shortness of breath, weakness, fatigue, lethargy, and bleeding. Physical examination results, both palpebral conjunctiva were pale. Laboratory examination results of a complete blood count, white blood cell count were 2,930/uL, hemoglobin 8.3 g/dL, Hct 24.10%, erythrocytes 2.78x106/µL, platelets 62,000/µL. Bone Marrow Aspiration (BMA) revealed Acute Promyelocytic Leukemia (APL).APL is a subtype of Acute Myelogenous Leukemia (AML). Persistent fatigue, recurrent infections, and bleeding are common manifestations of APL. The diagnosis of APL is made by bone marrow aspiration examination, and it is safe for pregnancy. APL therapy in pregnancy uses All-Trans Retinoic Acid (ATRA) and Arsenic Trioxide (ATO). ATRA and ATO are highly teratogenic, but recent studies have reported no fetal abnormalities.Accuracy and speed in diagnosing and initiating APL therapy in pregnancy are essential in preventing serious complications.

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Published

2024-04-01

How to Cite

Sisnawati, I. A., Salay, K., Fadillah, L. N., Jazilah, I., Mintarjo, J. A., Billah, A., Putra, A. S., Hersana, I. D. M. W., & Novita, C. (2024). A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report. Acta Medica Indonesiana, 56(1), 76. Retrieved from https://www.actamedindones.org/index.php/ijim/article/view/2373

Issue

Vol. 56 No. 1 (2024): Acta Medica Indonesiana

Section

CASE REPORT

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