Left Hemiparesis in Acute Myeloblastic Leukemia with High Mortality

Edward Kurnia Setiawan Limijadi; Noegroho  Harbani; Nani  Widorini; Imam  Budiwijono

doi:10.3889/oamjms.2020.4552

Authors

Edward Kurnia Setiawan Limijadi Department of Clinical Pathology, Medical Faculty, Diponegoro University, Semarang, Indonesia
Noegroho Harbani Department of Neurology, Ajibarang Government Hospital, Banyumas, Central Java, Indonesia
Nani Widorini Department of Internal Medicine, Ajibarang Government Hospital, Banyumas, Central Java, Indonesia
Imam Budiwijono Department of Clinical Pathology, Medical Faculty, Diponegoro University, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.4552

Keywords:

Hemiparesis, Acute myeloblastic leukemia, Mortality

Abstract

BACKGROUND: Leukemia is a blood malignancy that has a variety of types with a variety of clinical manifestations in the body organs in each patient. Acute myeloblastic leukemia (AML) occurs more frequently in adults with clinical manifestations in the central nervous system, especially on the M4 and M5 subtypes.

CASE REPORT: A 42-year-old woman came with a complaint of sudden left hemiparesis. The laboratory results obtained leukocytosis, normochromic normocytic anemia, and thrombocytopenia. Peripheral blood smear found immature cells of the myeloblasts and monoblasts series and monocytosis.

CONCLUSION: The conclusion of the clinical diagnosis and laboratory of the patient is left hemiparesis caused by AML with the suspect of subtype M4 or M5. Patients died within a few hours later, so bone marrow puncture and brain fluid retrieval for malignant cell analysis could not be performed. Brain fluid analysis is important to be performed to enforce the diagnosis of cerebral leukemia.

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References

Kavianpour M, Ahmadzadeh A, Shahrabi S, Saki N. Significance of oncogenes and tumor suppressor genes in AML prognosis. Tumour Biol. 2016;37(8):10041-52. https://doi.org/10.1007/ s13277-016-5067-1 PMid:27179964

Sitelbanat HO, Kordofani AA, Osman IM, Musa OH, Altayb HN, Elamin BK. Prevalence of the diffrent FAB sub type of acute myeloid leukemia related to hematological parameters in Sudanese. J Hematol Blood Disord. 2017;3(1):1-5. https://doi. org/10.15744/2455-7641.3.102

Alakel N, Stölzel F, Mohr B, Kramer M, Oelschlägel U, Röllig C, et al. Symptomatic central nervous system involvement in adult patients with acute myeloid leukemia. Cancer Manag Res. 2017;9:97. https://doi.org/10.2147/cmar.s125259 PMid:28435324

Shihadeh F, Reed V, Faderl S, Medeiros LJ, Mazloom A, Hadziahmetovic M, et al. Cytogenetic profile of patients with acute myeloid leukemia and central nervous system disease. Cancer. 2012;118(1):112. https://doi.org/10.1002/cncr.26253

Shahab F, Raziq F. Clinical presentations of acute leukemia. J Coll Physicians Surg Pak. 2017;24(7):472-6. PMid:25052968

Goy J, Smith T, Nantel S, Mourad YA, Broady R, Narayanan S, et al. The clinical and diagnostic pathway for adults with acute leukemia in BC. BC Med J. 2017;59(1):22-8.

Davis AS, Vierra AJ, Mead MD. Leukemia: An overview for primary care. Am Fam Physician. 2014;89(9):731-8.

Faivdullah L, Azahar F, Htike ZZ, Wei YN. Leukemia detection from blood smears. J Med Bio Eng. 2015;4(6):488-91. https:// doi.org/10.12720/jomb.4.6.488-491

Stefano VD, Sora F, Rossi E, Chiusolo P, Laurenti L, Fianchi L, et al. The risk of thrombosis in patients with acute leukemia: Occurence of thrombosis at diagnosis and during treatment. J Thromb Haemost. 2005;3(9):1985-92. https://doi. org/10.1111/j.1538-7836.2005.01467.x PMid:16102104

Algharras AA, Mamourian A, Coyne T, Mohan S. Leukostasis in an adult with AML presenting as multiple high attenuation brain masses on CT. J Clin Diagn Res. 2013;7(12):3020-2. https://doi. org/10.7860/jcdr/2013/6638.3893 PMid:24551717