Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction
We report the case of a 6-year-old boy diagnosed with acute promyelocytic leukemia (AML-M3V) when he presented with pallor, abdominal pain, anorexia, and fatigue. Induction chemotherapy was started according to the AML-BFM 98 protocol along with Vesanoid (ATRA, All-trans retinoic acid). On the sixth...
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2011
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| Online Access: | http://hdl.handle.net/10725/4044 http://dx.doi.org/10.1097/MBC.0b013e32834248e6 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/bloodcoagulation/Abstract/2011/03000/Acquired_protein_C_deficiency_in_a_child_with.12.aspx |
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| _version_ | 1864513462839803904 |
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| author | Farhat, Hussein |
| author2 | Farah, Roula A. Jalkh, Khalil S. Sayad, Paul E. Kadri, Adel M. |
| author2_role | author author author author |
| author_facet | Farhat, Hussein Farah, Roula A. Jalkh, Khalil S. Sayad, Paul E. Kadri, Adel M. |
| author_role | author |
| dc.creator.none.fl_str_mv | Farhat, Hussein Farah, Roula A. Jalkh, Khalil S. Sayad, Paul E. Kadri, Adel M. |
| dc.date.none.fl_str_mv | 2011 2016-06-15T09:45:35Z 2016-06-15T09:45:35Z 2016-06-15 |
| dc.identifier.none.fl_str_mv | 0957-5235 http://hdl.handle.net/10725/4044 http://dx.doi.org/10.1097/MBC.0b013e32834248e6 Farah, R. A., Jalkh, K. S., Farhat, H. Z., Sayad, P. E., & Kadri, A. M. (2011). Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction. Blood Coagulation & Fibrinolysis, 22(2), 140-143. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/bloodcoagulation/Abstract/2011/03000/Acquired_protein_C_deficiency_in_a_child_with.12.aspx |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Blood Coagulation & Fibrinolysis |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | We report the case of a 6-year-old boy diagnosed with acute promyelocytic leukemia (AML-M3V) when he presented with pallor, abdominal pain, anorexia, and fatigue. Induction chemotherapy was started according to the AML-BFM 98 protocol along with Vesanoid (ATRA, All-trans retinoic acid). On the sixth day of induction, he developed splenic and gallbladder infarcts. Splenectomy and cholecystectomy were performed while chemotherapy induction continued as scheduled. Four days later, he developed ischemic areas in the kidneys and ischemic colitis in the sigmoid colon. Hypercoagulation studies showed severe deficiency of protein C. Tests showed protein C 16% (reference range 70–140%), protein S 87% (reference range 70–140%), antithrombin III 122% (reference range 80–120%), prothrombin time 13.6 s (reference = 11.3), INR (international normalized ratio) 1.21, partial thromboplastin time 33 s (reference = 33), fibrinogen 214 mg/dl, D-dimer 970 μg/ml, factor II 98%, and that antinuclear antibody, antiphospholipid antibodies, mutation for factor II gene (G20210A), and mutation for Arg506 Gln of factor V were all negative (factor V Leiden). There was no evidence of clinical disseminated intravascular coagulation (DIC). He was treated with low molecular weight heparin and did well. He continues to be in complete remission 7 years later with normal protein C levels. Acquired protein C deficiency can occur in a variety of settings and has been reported in acute myelocytic leukemia. However, clinically significant thrombosis in the absence of clinical DIC, such as our case, remains extremely rare. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_4cc75adeecee2f32ceb51655d6a7c123 |
| identifier_str_mv | 0957-5235 Farah, R. A., Jalkh, K. S., Farhat, H. Z., Sayad, P. E., & Kadri, A. M. (2011). Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction. Blood Coagulation & Fibrinolysis, 22(2), 140-143. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4044 |
| publishDate | 2011 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarctionFarhat, HusseinFarah, Roula A.Jalkh, Khalil S.Sayad, Paul E.Kadri, Adel M.We report the case of a 6-year-old boy diagnosed with acute promyelocytic leukemia (AML-M3V) when he presented with pallor, abdominal pain, anorexia, and fatigue. Induction chemotherapy was started according to the AML-BFM 98 protocol along with Vesanoid (ATRA, All-trans retinoic acid). On the sixth day of induction, he developed splenic and gallbladder infarcts. Splenectomy and cholecystectomy were performed while chemotherapy induction continued as scheduled. Four days later, he developed ischemic areas in the kidneys and ischemic colitis in the sigmoid colon. Hypercoagulation studies showed severe deficiency of protein C. Tests showed protein C 16% (reference range 70–140%), protein S 87% (reference range 70–140%), antithrombin III 122% (reference range 80–120%), prothrombin time 13.6 s (reference = 11.3), INR (international normalized ratio) 1.21, partial thromboplastin time 33 s (reference = 33), fibrinogen 214 mg/dl, D-dimer 970 μg/ml, factor II 98%, and that antinuclear antibody, antiphospholipid antibodies, mutation for factor II gene (G20210A), and mutation for Arg506 Gln of factor V were all negative (factor V Leiden). There was no evidence of clinical disseminated intravascular coagulation (DIC). He was treated with low molecular weight heparin and did well. He continues to be in complete remission 7 years later with normal protein C levels. Acquired protein C deficiency can occur in a variety of settings and has been reported in acute myelocytic leukemia. However, clinically significant thrombosis in the absence of clinical DIC, such as our case, remains extremely rare.PublishedN/A2016-06-15T09:45:35Z2016-06-15T09:45:35Z20112016-06-15Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0957-5235http://hdl.handle.net/10725/4044http://dx.doi.org/10.1097/MBC.0b013e32834248e6Farah, R. A., Jalkh, K. S., Farhat, H. Z., Sayad, P. E., & Kadri, A. M. (2011). Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction. Blood Coagulation & Fibrinolysis, 22(2), 140-143.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://journals.lww.com/bloodcoagulation/Abstract/2011/03000/Acquired_protein_C_deficiency_in_a_child_with.12.aspxenBlood Coagulation & Fibrinolysisinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/40442021-03-19T10:00:54Z |
| spellingShingle | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction Farhat, Hussein |
| status_str | publishedVersion |
| title | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| title_full | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| title_fullStr | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| title_full_unstemmed | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| title_short | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| title_sort | Acquired protein C deficiency in a child with acute myelogenous leukemia, splenic, renal, and intestinal infarction |
| url | http://hdl.handle.net/10725/4044 http://dx.doi.org/10.1097/MBC.0b013e32834248e6 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/bloodcoagulation/Abstract/2011/03000/Acquired_protein_C_deficiency_in_a_child_with.12.aspx |