Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management

Background. Acute promyelocytic leukemia is characterized by t(15;17). This leads to the formation of PML/RARα which blocks the differentiation of blasts at the stage of promyelocytes. This is reversed by all-trans-retinoic acid (ATRA), a vitamin A derivative. Acute myocardial ischemia is a rare sid...

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Main Authors: K. Govind Babu, K. N. Lokesh, M. C. Suresh Babu, Gita R. Bhat
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2016/2829142
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author K. Govind Babu
K. N. Lokesh
M. C. Suresh Babu
Gita R. Bhat
author_facet K. Govind Babu
K. N. Lokesh
M. C. Suresh Babu
Gita R. Bhat
author_sort K. Govind Babu
collection DOAJ
description Background. Acute promyelocytic leukemia is characterized by t(15;17). This leads to the formation of PML/RARα which blocks the differentiation of blasts at the stage of promyelocytes. This is reversed by all-trans-retinoic acid (ATRA), a vitamin A derivative. Acute myocardial ischemia is a rare side effect of ATRA. Case Report. We report a case of acute coronary syndrome manifesting as an adverse effect of ATRA in a lady with APL who had no other risk factors for cardiovascular disease. Conclusions. We emphasize the need for high index of suspicion for the diagnosis of this entity. In the light of this case, the rare instances of ATRA associated acute myocardial ischemia recorded in the literature and the options available for treatment of acute promyelocytic leukemia sans ATRA have been reviewed.
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institution Kabale University
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series Case Reports in Oncological Medicine
spelling doaj-art-08d4874b0ed64210ae0ef750a30ea34e2025-08-20T03:55:32ZengWileyCase Reports in Oncological Medicine2090-67062090-67142016-01-01201610.1155/2016/28291422829142Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on ManagementK. Govind Babu0K. N. Lokesh1M. C. Suresh Babu2Gita R. Bhat3Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M. H. Marigowda Road, Hombegowda Nagar, Bengaluru, Karnataka 560030, IndiaDepartment of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M. H. Marigowda Road, Hombegowda Nagar, Bengaluru, Karnataka 560030, IndiaDepartment of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M. H. Marigowda Road, Hombegowda Nagar, Bengaluru, Karnataka 560030, IndiaDepartment of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M. H. Marigowda Road, Hombegowda Nagar, Bengaluru, Karnataka 560030, IndiaBackground. Acute promyelocytic leukemia is characterized by t(15;17). This leads to the formation of PML/RARα which blocks the differentiation of blasts at the stage of promyelocytes. This is reversed by all-trans-retinoic acid (ATRA), a vitamin A derivative. Acute myocardial ischemia is a rare side effect of ATRA. Case Report. We report a case of acute coronary syndrome manifesting as an adverse effect of ATRA in a lady with APL who had no other risk factors for cardiovascular disease. Conclusions. We emphasize the need for high index of suspicion for the diagnosis of this entity. In the light of this case, the rare instances of ATRA associated acute myocardial ischemia recorded in the literature and the options available for treatment of acute promyelocytic leukemia sans ATRA have been reviewed.http://dx.doi.org/10.1155/2016/2829142
spellingShingle K. Govind Babu
K. N. Lokesh
M. C. Suresh Babu
Gita R. Bhat
Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
Case Reports in Oncological Medicine
title Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
title_full Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
title_fullStr Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
title_full_unstemmed Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
title_short Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management
title_sort acute coronary syndrome manifesting as an adverse effect of all trans retinoic acid in acute promyelocytic leukemia a case report with review of the literature and a spotlight on management
url http://dx.doi.org/10.1155/2016/2829142
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