Abstract
Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment. The report highlights the crucial role of early diagnosis and subsequent chemotherapy in avoiding amputation. We particularly focused critical and emotional aspects related to the communication about the leg amputation with the patient and his family.
Highlights
A 13l year-old boy with a previously undiagnosed ia acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower rc limb due to occlusion of the right external iliac artery, treated with emergency double surgical e thromboembolectomy and chemotherapy
We focused n critical and emotional aspects related to the o communication about the leg amputation with N the patient and his family
A 13-year-old boy suffering from fever for 6 days, as well as pain and paresthesia at the right feet, was admitted to our Emergency Unit and immediately underwent angiographic computed tomography (CT) that showed the occlusion of the right external iliac artery (Figure 1A)
Summary
Department, A.R.N.A.S Civico, Di Cristina Case Report manuscript reviewing; PD, CT, PG, AT, FV and FT were involved in the clinical management e Benfratelli Hospitals, Palermo, Italy nly Abstract e o Large vessel thrombosis is a very rare clinis cal presentation of acute leukemia, generally associated with coagulopathy, usually characu teristic of acute promyelocytic leukemia. A 13l year-old boy with a previously undiagnosed ia acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower rc limb due to occlusion of the right external iliac artery, treated with emergency double surgical e thromboembolectomy and chemotherapy. A 13-year-old boy suffering from fever for 6 days, as well as pain and paresthesia at the right feet, was admitted to our Emergency Unit and immediately underwent angiographic computed tomography (CT) that showed the occlusion of the right external iliac artery (Figure 1A). The boy underwent immediate surgical thromboembolectomy of the right iliac and femural arteries immediately, and subsequently continuous infusion of heparin and urokinase. The vascular tree appeared diffusely stuffed by abundant lard-like material consisting of recently formed neoplastic tissue After this second procedure physical examination of the feet was consistent with a possible recovery of the vascular damage. 140%), while the study of lupus anticoagulant, the dose of 200 mg/sqm/day, with the aim of
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