Cerebral Venous Sinuses Thrombosis in Acute Promyelocytic Leukaemia Treatment with All-trans Retinoic Acid (ATRA)

1. Mohd Faizal, Haron¹
2. Visvaraja, Subrayan²
3. D.K, Patel²
4. C.L, Wong²

¹University Malaya Medical Center, Kuala Lumpur, Malaysia
²Penang General Hospital, Penang, Malaysia

Purpose
To report a case of cerebral venous sinuses thrombosis in acute promyelocytic leukaemia during treatment with all-trans retinoic acid (ATRA)

Method
22 years old, Malay girl with was diagnosed with acute promyelocytic leukaemia in August 2010. While she was on chemotherapy (T. ATRA and IV Idarubicin), she complained of blurring of vision in the right eye over 1 week duration. Vision was OD 6/12 and OS 6/9. Anterior segment examination was normal. Fundus showed papilloedema with flame-shaped haemorrhages. An MRI brain was done on 21.9.10 and showed cerebral venous sinuses thrombosis.

Results
She was diagnosed to have cerebral venous thrombosis and was started on intravenous heparin infusion and later switched to warfarin. She was reviewed 2 weeks later and the peripapillary haemorrhages reduced significantly.

Conclusions
Venous sinuses thrombosis is a rare complication of treatment with all-trans retinoic acid for acute promyelocytic leukaemia