Acute myelogenous leukemia mimicking a hemolysis, elevated liver enzymes, and low platelets syndrome during pregnancy: case report and review of the literature

• Published in: American journal of perinatology Vol. 24; no. 1; p. 1
• Main Authors: Aboujaoude, Ramzi, Alvarez, Jesus, Alvarez, Manuel, Al Khan, Abdullah
• Format: Journal Article
• Language: English
• Published: United States 01.01.2007
• Subjects: Adult; Diagnosis, Differential; Fatal Outcome; Female; Fetal Death; Hemolysis; Humans; Leukemia, Monocytic, Acute - blood; Leukemia, Monocytic, Acute - complications; Leukemia, Monocytic, Acute - diagnosis; Leukemia, Monocytic, Acute - pathology; Liver - enzymology; Platelet Transfusion; Pregnancy; Pregnancy Complications, Neoplastic - blood; Pregnancy Complications, Neoplastic - diagnosis; Pregnancy Complications, Neoplastic - pathology; Pregnancy Trimester, Third; Prenatal Diagnosis; Thrombocytopenia - blood; Thrombocytopenia - etiology
• ISSN: 0735-1631; 1098-8785
• DOI: 10.1055/s-2006-954955

Acute leukemia is a rare malignancy of pregnancy. When it develops, there are many complications to consider and management becomes exceedingly difficult. We report a case of acute myelogenous leukemia presenting as preeclampsia and fetal demise at 36 weeks of gestation. A 30-year-old multigravida presented with intrauterine fetal demise at 36 weeks' gestation, hypertension, and thrombocytopenia. The patient received platelet and packed red blood cell transfusion, with concurrent prophylactic magnesium sulfate and dexamethasone treatment. Following labor induction, the patient delivered a nonviable female fetus and suffered a stroke postpartum. Peripheral smear and flow cytometry revealed the patient had acute myeloid leukemia with prominent monocytic differentiation. The patient expired on postpartum day six. Acute leukemia during the pregnancy is associated with an unfavorable outcome.