ATRA-induced cerebral sinus thrombosis.
J Thromb Thrombolysis, 2014/7;38(1):87-9.
Lee KR[1], Subrayan V, Win MM, Fadhilah Mohamad N, Patel D
Affiliations
PMID: 24046068DOI: 10.1007/s11239-013-0988-7
Impact factor: 5.221
Abstract
All-trans retinoic acid (ATRA) and Idarubicin are part of the AIDA protocol employed for the treatment of Acute promyelocytic leaukaemia (APML) and has been associated with marked improvement in the prognosis. However, it is known to worsen the haematological picture during the course of induction of therapy. Herein, we present a case of an APML patient who developed a rare documented incidence of cerebral sinus thrombosis, first noticed as an ophthalmology referral. This 22 year old lady, a known APML patient was then started on chemotherapy based on AIDA protocol but 17 days into the initiation of therapy, she began to complain of blurred vision on the right eye. Anterior segments were normal but both fundi showed papilloedema with peripapillary haemorrhages. A contrast MRI that was then ordered showed multiple filling defects in numerous venous sinuses. She was started on anticoagulant treatment and the findings resolved. Though a rare case of its side-effects, ATRA usage in APML has a multitude of presentations since its primary pathology lies in the inherent pro-coagulant potential.
MeSH terms
Adult; Antineoplastic Agents; Cerebral Angiography; Female; Humans; Intracranial Thrombosis; Leukemia, Promyelocytic, Acute; Magnetic Resonance Angiography; Tretinoin
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