Atypical Presentation of Acute Myeloid Leukemia.
World J Oncol. 2018 Feb;9(1):29-34
Authors: Agrawal Ok, Miles L, Agrawal N, Khan A
We current a case of a 48-year-old male who offered with worsening pleuritic chest ache for two h. He additionally complained of fever, malaise, headache and extreme neck ache. Electrocardiogram (ECG) confirmed ST phase elevation in leads I, II, aVL and V5 with PR elevation and ST melancholy in aVR. On admission, troponin-I used to be 14.eight ng/mL. Primarily based on ECG adjustments, elevated troponin and household historical past of early coronary artery illness, the affected person was emergently taken to cardiac catheterization lab. Angiography confirmed non-obstructive coronaries, delicate hypokinesis of mid inferior and anterolateral wall with ejection fraction (EF) of 40-45%. Primarily based on above presentation and angiography findings, the analysis of acute myopericarditis was made. He was began on colchicine and ibuprofen. The opposite workup to find out etiology of myopericarditis was unfavorable as proven beneath. Given the historical past of fever, headache and worsening neck ache, we additionally grew to become suspicious of meningitis. Lumbar puncture was carried out which was unfavorable. On the day of admission, he was discovered to have blasts on full blood rely and peripheral smear. Bone marrow biopsy and stream cytometry confirmed the analysis of acute myeloid leukemia (AML). He obtained induction and salvage remedy. Repeat bone marrow confirmed full remission and regular cytogenetics. Though pericardial or myocardial biopsies are unavailable for our affected person, within the absence of different causes, it does seem that his acute myopericarditis was related to AML.
PMID: 29581813 [PubMed]