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- Title
Pseudotumour cerebri in acute promyelocytic leukemia on treatment with all-trans-retinoic acid (ATRA) - an experience from a teritiary care centre.
- Authors
TALI, Manzoor AHMAD; BASHIR, Yasir; BHAT, Shuaeb; MANZOOR, Fahim; BASHIR, Nusrat; GEELANI, Sajad; RASOOL, Javid; MIR, Abdul WAHEED
- Abstract
Acute promyelocytic leukemia (APML) is considered to be sensitive to all-trans-retinoic acid (ATRA) which acts as a differentiating agent. ATRA is considered to be a well-tolerated agent and is known to achieve complete remission in acute promyelocytic leukemia. However, a few cases on long term all-trans-retinoic acid (ATRA) use can develop pseudotumor cerebri. Out of 32 patients with APML who were treated in our Centre over a 4-year-period, we encountered 6 patients who developed ATRA-related pseudotumor cerebri while on maintenance treatment. The patients ranged from 12 to 40 years of age. 3 patients complained of unbearable headache, 2 of diplopia and 1 of gross reduction in visual acuity. CT scans and MRI did not reveal any intracranial lesions. Cerebrospinal fluid (CSF) examination was normal with CSF manometry revealing a high CSF pressure (average of 345mmH2O). Fundoscopy revealed papilledema in 5 patients and optic atrophy in 1 patient. The patients were successfully managed with decrease dose/discontinuation of ATRA, use of acetazolamide, corticosteroids and therapeutic CSF drainage.
- Subjects
INTRACRANIAL hypertension; TREATMENT of acute promyelocytic leukemia; TRETINOIN; TERTIARY care; MEDICAL centers; DISEASE remission; DIAGNOSIS; THERAPEUTICS
- Publication
Malaysian Journal of Pathology, 2015, Vol 37, Issue 2, p141
- ISSN
0126-8635
- Publication type
Article