Pseudotumor Cerebri by Administration of All-Trans Retinoic Acid(ATRA) in a Patient with Acute Promyelocytic Leukemia(APL).
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We describe a 12 year-old boy with acute promyelocytic leukemia (APL, M3) who showed pseudotumor cerebri after administration of all-trans retinoic acid (ATRA). He wasadmitted to our hospital with anemia and thrombocytopenia. On admission, increased abnormal promyelocytes and PML-RARa chimeric mRNA were detected in bone marrow aspirate and laboratory tests. He was diagnosed as APL and the administration of ATRA 45 mg/m<SUP>2</SUP>/day was started immediately. He showed the complication of disseminated intravascular coagulation (DIC). On the second day after starting the therapy, he experienced severe headache and frequent vomiting. Intracranial hemorrhage was suspected, but a brain CT scan revealed no sign of intracranial hemorrhage. We induced relief for his headache after the administration of hydrocortisone to prevent allergic reaction to the administration of platelet transfusion. We diagnosed this episode as pseudotumor cerebri caused by treatment with ATRA. Thereby he received hydrocortisone as a prophylaxis for headache and his episode of headache diminished after that. Some investigators have reported that pseudotumor cerebri is one of the dose-limiting factors of ATRA administration. Our results suggest that steroid hormone is effective to control pseudotumor cerebri due to ATRA. Co-administration of steroid hormone withATRA may be an efficient strategy for induction therapy with ATRA for APL.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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