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

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...

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Main Authors: Ismy Azizah Sisnawati, Kezia Salay, Listiana Nur Fadillah, Indi Jazilah, Jessica Amelinda Mintarjo, Atiyatum Billah, Agung Sunarko Putra, I Dewa Made Widi Hersana, Citra Novita
Format: Article
Language:English
Published: Interna Publishing 2024-04-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2373
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author Ismy Azizah Sisnawati
Kezia Salay
Listiana Nur Fadillah
Indi Jazilah
Jessica Amelinda Mintarjo
Atiyatum Billah
Agung Sunarko Putra
I Dewa Made Widi Hersana
Citra Novita
author_facet Ismy Azizah Sisnawati
Kezia Salay
Listiana Nur Fadillah
Indi Jazilah
Jessica Amelinda Mintarjo
Atiyatum Billah
Agung Sunarko Putra
I Dewa Made Widi Hersana
Citra Novita
author_sort Ismy Azizah Sisnawati
collection DOAJ
description 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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spelling doaj-art-bdcf6eae50e74625b152bbca1f4db3b72025-08-20T02:37:16ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322024-04-01561A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case ReportIsmy Azizah Sisnawati0Kezia Salay1Listiana Nur Fadillah2Indi Jazilah3Jessica Amelinda Mintarjo4Atiyatum Billah5Agung Sunarko Putra6I Dewa Made Widi Hersana7Citra Novita8Faculty of Medicine, Hang Tuah University, Surabaya, IndonesiaFaculty of Medicine, Hang Tuah University, Surabaya, IndonesiaFaculty of Medicine, Hang Tuah University, Surabaya, IndonesiaFaculty of Medicine, Hang Tuah University, Surabaya, IndonesiaFaculty of Medicine, Hang Tuah University, Surabaya, IndonesiaFaculty of Medicine, Hang Tuah University, Surabaya, IndonesiaDepartment of Obstetrics and Gynecology, Dr. Ramelan Navy Hospital, Surabaya, IndonesiaDepartment of Internal Medicine, Dr. Ramelan Navy Hospital, Surabaya, IndonesiaDepartment of Clinical Pathology, Dr. Ramelan Navy Hospital, Surabaya, Indonesia 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. http://www.actamedindones.org/index.php/ijim/article/view/2373Acute promyelocytic leukemiapregnancy
spellingShingle Ismy Azizah Sisnawati
Kezia Salay
Listiana Nur Fadillah
Indi Jazilah
Jessica Amelinda Mintarjo
Atiyatum Billah
Agung Sunarko Putra
I Dewa Made Widi Hersana
Citra Novita
A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
Acta Medica Indonesiana
Acute promyelocytic leukemia
pregnancy
title A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
title_full A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
title_fullStr A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
title_full_unstemmed A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
title_short A Life-Threatening Complication During the Fourth Pregnancy Due to Acute Promyelocytic Leukemia: A Case Report
title_sort life threatening complication during the fourth pregnancy due to acute promyelocytic leukemia a case report
topic Acute promyelocytic leukemia
pregnancy
url http://www.actamedindones.org/index.php/ijim/article/view/2373
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