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

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2017.1375722 · Published: September 1, 2018

Spinal Cord Injury Oncology Rehabilitation

Simple Explanation

Fever is a common issue for individuals with spinal cord injuries during rehabilitation, often stemming from infections or other non-infectious causes. However, sometimes the cause remains unidentified, necessitating further investigation to rule out less common conditions. This case report presents an instance of a patient with tetraplegia developing acute promyelocytic leukemia (APL) during inpatient rehabilitation, which is a rare occurrence. Early diagnosis and treatment of APL are crucial due to its association with life-threatening complications such as disseminated intravascular coagulation (DIC), which can lead to hemorrhage and thrombosis.

Study Duration

10.5 months

Participants

A 47 year-old male with C4 AIS A complete tetraplegia

Evidence Level

Level 4: Case Report

Key Findings

1
A patient with tetraplegia developed acute promyelocytic leukemia (APL) while undergoing inpatient rehabilitation.
2
The patient presented with fever, thrombocytopenia, and anemia, leading to the diagnosis of APL.
3
No prior association has been established between traumatic spinal cord injury and the development of acute leukemia, making this a unique case report.

Research Summary

This case report describes the development of acute promyelocytic leukemia (APL) in a 47-year-old male with tetraplegia during inpatient rehabilitation. The patient presented with fever, thrombocytopenia, and anemia 20 months after his injury, leading to the diagnosis of APL, which was confirmed by bone marrow biopsy. The authors emphasize the importance of considering less common causes of fever in spinal cord injury patients, even during inpatient rehabilitation, to ensure timely diagnosis and treatment of life-threatening conditions like APL.

Practical Implications

Clinical Vigilance

Maintain a high index of suspicion for unusual causes of fever in spinal cord injury patients, even during inpatient rehabilitation.

Early Diagnosis of APL

Prompt diagnosis and treatment of APL are critical due to its potential for life-threatening complications.

Further Research

Further investigation is needed to determine if there is an association between spinal cord injury and the development of acute leukemias.

Study Limitations

1
Single case report limits generalizability.
2
Lack of comparative data on leukemia prevalence in the SCI population.
3
Possible confounding factors related to the patient's medical history and complications.

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