Michael Kucharik1*, David Waldburg1, Anitha Chandran1, Alison Kohn1 and Roozbeh Nazarian1,2
1Department of Internal Medicine, Florida Atlantic University, USA 2Department of Internal Medicine, Boca Raton Regional Hospital, USAFulltext PDF
We would like to present a case of Acute Myeloid Leukemia (AML) with myelodysplasia-related changes that presented as thrombotic Thrombocytopenic Purpura (TTP). Our patient presented to with the classic pentad of TTP symptoms: anemia, thrombocytopenia, fever, elevated creatinine, and altered mental status. After a failure to respond to plasmapheresis therapy, we proceeded with a bone marrow biopsy and fluorescent in situ hybridization, which supported formal diagnosis of acute myeloid leukemia with myelodysplasia-related changes. Our case is an extremely rare presentation of a rare condition, as there have been no reported cases of acute myeloid leukemia with myelodysplasia-related changes presenting as thrombocytopenic thrombotic purpura. This case highlights the importance of a high clinical index of suspicion for acute myeloid leukemia in patients who present with unexplained cytopenias and constitutional symptoms even when there are distracting symptoms and an absence of blasts on peripheral smear.
Thrombotic thrombocytopenic purpura; Acute myeloid leukemia; Microangiopathic hemolytic anemia; Ttp; Aml; Myelodysplastic; Thrombocytopenia
Kucharik M, Waldburg D, Chandran A, Kohn A, Nazarian R. Acute Myeloid Leukemia Presenting as Thrombotic Thrombocytopenic Purpura: A Case Report. Ann Clin Case Rep. 2019; 4: 1777.