Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report

Valve vegetation is one of the most fearful findings for physicians. The first diagnosis that comes to their mind is infective endocarditis (IE), but it can also be noninfective; nonbacterial thrombotic endocarditis (NBTE). NBTE can be even more challenging than IE for physicians because of the wide...

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Autores principales:	Tadayuki Hashimoto, Tatsuya Aoki, Yoshitaka Kawabata, Yoshihiro Owai, Yoshikazu Matsuda, Shinobu Tamura
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	nonbacterial thrombotic endocarditis (NBTE) leukemic cell acute promyelocytic leukemia anticoagulation therapy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/122d27741ef34765b601687f44bad1c0
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spelling	oai:doaj.org-article:122d27741ef34765b601687f44bad1c02021-11-25T18:19:03ZNonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report10.3390/medicina571112641648-91441010-660Xhttps://doaj.org/article/122d27741ef34765b601687f44bad1c02021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1264https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144Valve vegetation is one of the most fearful findings for physicians. The first diagnosis that comes to their mind is infective endocarditis (IE), but it can also be noninfective; nonbacterial thrombotic endocarditis (NBTE). NBTE can be even more challenging than IE for physicians because of the wide range of differential diagnoses such as malignancies, autoimmune disorders and human immunodeficiency virus. A 45-year-old woman presented at the emergency room with a sudden onset of dysarthria and right-sided hemiplegia. Laboratory data showed her blood counts and coagulation test were mostly normal and the magnetic resonance imaging detected a high-signal-intensity change in her left brain. An echocardiogram found a vegetation-like structure on her atrial valve. We highly suspected IE leading to cerebral embolism. The clot was successfully removed by our neurosurgeons and anticoagulation therapy was started concurrently. Her state of consciousness improved, but then she suffered a brain hemorrhage and died. The autopsy revealed that the cause of her vegetation was acute promyelocytic leukemia (APL). Based on these findings, it is important to remember that APL can be the cause of NBTE even if the blood count and coagulation tests are almost normal.Tadayuki HashimotoTatsuya AokiYoshitaka KawabataYoshihiro OwaiYoshikazu MatsudaShinobu TamuraMDPI AGarticlenonbacterial thrombotic endocarditis (NBTE)leukemic cellacute promyelocytic leukemiaanticoagulation therapyMedicine (General)R5-920ENMedicina, Vol 57, Iss 1264, p 1264 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	nonbacterial thrombotic endocarditis (NBTE) leukemic cell acute promyelocytic leukemia anticoagulation therapy Medicine (General) R5-920
spellingShingle	nonbacterial thrombotic endocarditis (NBTE) leukemic cell acute promyelocytic leukemia anticoagulation therapy Medicine (General) R5-920 Tadayuki Hashimoto Tatsuya Aoki Yoshitaka Kawabata Yoshihiro Owai Yoshikazu Matsuda Shinobu Tamura Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
description	Valve vegetation is one of the most fearful findings for physicians. The first diagnosis that comes to their mind is infective endocarditis (IE), but it can also be noninfective; nonbacterial thrombotic endocarditis (NBTE). NBTE can be even more challenging than IE for physicians because of the wide range of differential diagnoses such as malignancies, autoimmune disorders and human immunodeficiency virus. A 45-year-old woman presented at the emergency room with a sudden onset of dysarthria and right-sided hemiplegia. Laboratory data showed her blood counts and coagulation test were mostly normal and the magnetic resonance imaging detected a high-signal-intensity change in her left brain. An echocardiogram found a vegetation-like structure on her atrial valve. We highly suspected IE leading to cerebral embolism. The clot was successfully removed by our neurosurgeons and anticoagulation therapy was started concurrently. Her state of consciousness improved, but then she suffered a brain hemorrhage and died. The autopsy revealed that the cause of her vegetation was acute promyelocytic leukemia (APL). Based on these findings, it is important to remember that APL can be the cause of NBTE even if the blood count and coagulation tests are almost normal.
format	article
author	Tadayuki Hashimoto Tatsuya Aoki Yoshitaka Kawabata Yoshihiro Owai Yoshikazu Matsuda Shinobu Tamura
author_facet	Tadayuki Hashimoto Tatsuya Aoki Yoshitaka Kawabata Yoshihiro Owai Yoshikazu Matsuda Shinobu Tamura
author_sort	Tadayuki Hashimoto
title	Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
title_short	Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
title_full	Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
title_fullStr	Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
title_full_unstemmed	Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
title_sort	nonbacterial thrombotic endocarditis associated with acute promyelocytic leukemia: an autopsy case report
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/122d27741ef34765b601687f44bad1c0
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Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report

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