Development of acute promyelocytic leukemia in a patient with tetraplegia while in inpatient rehabilitation: A case report

J Spinal Cord Med. 2018 Sep;41(5):571-574. doi: 10.1080/10790268.2017.1375722. Epub 2017 Sep 20.

Abstract

Study design: a single case report.

Objectives: To report a case of a patient with tetraplegia who developed acute promyelocytic leukemia (APL) while in inpatient rehabilitation after 10.5 months.

Setting: A VA Medical Center Spinal Cord Injury Service and Disorders Unit Case Report: A 47 year-old male with a stage IV sacral pressure ulcer and C4 AIS A complete tetraplegia secondary to a motor vehicle collision, developed fever, thrombocytopenia, and anemia 20 months after his injury while in inpatient rehabilitation and was found to have APL, confirmed following bone marrow biopsy.

Conclusion: There is a wide differential for fever after a spinal cord injury. In this case report, the source of fever was APL. It is important as healthcare providers to not overlook fevers when otherwise common causes do not fit the clinical picture. Additionally, there has been no association found between traumatic spinal cord injury and the development of acute leukemia, however this is the first case report. Therefore, it is important to continue investigating to determine if an association exists.

Keywords: Acute promyelocytic leukemia; Fever; Rehabilitation; Spinal cord injury; Tetraplegia; Thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Leukemia, Promyelocytic, Acute / complications*
  • Leukemia, Promyelocytic, Acute / etiology
  • Male
  • Middle Aged
  • Quadriplegia / complications*
  • Quadriplegia / rehabilitation
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / rehabilitation