Diffuse alveolar hemorrhage with underlying pulmonary capillaritis in the retinoic acid syndrome

Mark R. Nicolls, Lance S. Terada, Rubin M. Tuder, Sheila A. Prindiville, Marvin I. Schwarz

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

All-trans-retinoic acid (ATRA) can induce a clinical remission in patients with acute promyelocytic leukemia. An adverse condition called 'retinoic acid syndrome' limits this therapy. It is characterized by fever and respiratory distress, along with weight gain, pleural or pericardial effusions, peripheral edema, thromboembolic events, and intermittent hypotension. The lung disease has been previously ascribed to an infiltration of leukemic or maturing myeloid cells into lung parenchyma, which is sometimes associated with pleural effusions and diffuse alveolar hemorrhage. We report a case of retinoic acid syndrome in an 18-yr-old woman who developed diffuse alveolar hemorrhage while being treated with ATRA for acute promyelocytic leukemia. An open lung biopsy revealed pulmonary capillaritis.

Original languageEnglish (US)
Pages (from-to)1302-1305
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Volume158
Issue number4
DOIs
StatePublished - Jan 1 1998

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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