Cerebral vein thrombosis as the initial presentation of acute promyelocytic leukemia (APML)

Cerebral vein thrombosis as the initial presentation of acute promyelocytic leukemia (APML)

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Abstract A 33-year-old woman with morbid obesity, positive IgM cardiolipin antibody, and recurrent venous thromboembolism on weight-based enoxaparin treatment developed severe headaches during her click here 9th week of pregnancy and was diagnosed with cerebral vein thrombosis (CVT).She was treated with enoxaparin (1 mg/kg) 240 mg twice daily, after a few days of intravenous heparin.Her complete blood count showed mild pancytopenia, with normal peripheral smear.She had a normal bone marrow biopsy done due to leukocytosis a year ago.

She few days later presented to our emergency department turbosound ts-18sw700/8a (ED) with worsening headache and photophobia.Workup revealed normal anti-Xa activity despite weight-based enoxaparin, CVT, and a new diagnosis of acute promyelocytic leukemia.While it is known that APML predisposes to thrombotic events, there is limited literature that reports enoxaparin-resistant CVT as an initial manifestation of APML.It is important for clinicians to be aware that occurrence of unusual thromboembolism may herald APML.