Case Report

Archives of Gynecology and Obstetrics

, Volume 277, Issue 3, pp 267-270

Acute promyelocytic leukemia: an unusual cause showing prolonged disseminated intravascular coagulation after placental abruption

  • Yukako MorimatsuAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University
  • , Shigeki MatsubaraAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University Email author 
  • , Noriko HiroseAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University
  • , Akihide OhkuchiAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University
  • , Akio IzumiAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University
  • , Katsutoshi OzakiAffiliated withDivision of Hematology, Department of Medicine, Jichi Medical University
  • , Keiya OzawaAffiliated withDivision of Hematology, Department of Medicine, Jichi Medical University
  • , Mitsuaki SuzukiAffiliated withDepartment of Obstetrics and Gynecology, Jichi Medical University

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Abstract

Background

Disseminated intravascular coagulation (DIC) caused by placental abruption usually improves rapidly after prompt delivery and adequate anti-DIC treatment.

Case

A 30-year-old nulliparous woman suffered from placental abruption at the 25th week of pregnancy, and emergent cesarean section was done immediately. She exhibited DIC, which continued even after termination of the pregnancy and anti-DIC treatment. She also showed neutropenia. We closely observed her, and at the 58th day postpartum, blast cells appeared in the peripheral blood and she was diagnosed with acute promyelocytic leukemia (APL). Induction chemotherapy was done successfully. The close observation after delivery enabled us to make the prompt diagnosis/treatment, leading to the complete remission.

Conclusion

APL should be added to the list of differential diagnosis when DIC persists even after prompt delivery and appropriate anti-DIC treatment after placental abruption.

Keywords

Acute promyelocytic leukemia Disseminated intravascular coagulation Placental abruption