mercaptopurine and Cerebral-Hemorrhage

Topics: Anti-Inflammatory Agents; Antibodies, Monoclonal, Humanized; Cerebral Hemorrhage; Certolizumab Pegol; Colitis, Ulcerative; Diagnosis, Differential; Drug Therapy, Combination; Humans; Immunoglobulin Fab Fragments; Immunosuppressive Agents; Intracranial Thrombosis; Magnetic Resonance Imaging; Male; Mercaptopurine; Middle Aged; Polyethylene Glycols; Prednisone; Tomography, X-Ray Computed

A 24 year-old female was admitted because of hypermenorrhea and petechiae. The peripheral blood tests on admission were consistent with acute promyelocytic leukemia complicated with DIC. BHAC-DMP therapy was started along with platelet transfusions and heparin administration. On the day 9 of admission, on the contrary to the improvement of hematological data, the patient suffered from severe headache and nausea. The neurological examination revealed anisocoria. Right side chronic subdural hematoma was a diagnosis made by emergency CT scan and was treated with drainage of the hematoma. Post-operatively, the patient did well, and achieved complete remission on the day 43 of admission. Since intracranial hemorrhages due to DIC complicated with leukemia are often fatal, those patients are usually treated conservatively. However, as shown in this case report, some cases might have an indication for the neurosurgical operation. It is important to check conditions carefully whether the patient has an indication for the operation.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cerebral Hemorrhage; Cytarabine; Daunorubicin; Disseminated Intravascular Coagulation; Drainage; Female; Hematoma, Subdural; Humans; Leukemia, Promyelocytic, Acute; Mercaptopurine; Prednisolone; Remission Induction

Topics: Amphetamine; Ataxia; Bone Marrow; Cerebral Hemorrhage; Depression, Chemical; Dicumarol; Dihydroxyphenylalanine; Disulfiram; Drug Antagonism; Ephedrine; Humans; Hypertension; Hypotension; Isoniazid; Mercaptopurine; Methamphetamine; Microsomes, Liver; Monoamine Oxidase Inhibitors; Norepinephrine; Phenethylamines; Phenytoin; Reserpine; Stimulation, Chemical; Thiazines; Thiopental; Tyramine

Topics: Cerebral Hemorrhage; Geriatrics; Leukemia; Leukemia, Myeloid; Mercaptopurine; Neurologic Manifestations; Pathology

Topics: Adolescent; Adrenal Cortex Hormones; Anti-Bacterial Agents; Antimetabolites; Antineoplastic Agents; Blood Transfusion; Cerebral Hemorrhage; Child; Hemorrhagic Disorders; Humans; Infant; Leukemia; Leukemia, Myeloid; Mercaptopurine; Neoplasms; Photomicrography; Sepsis; Toxicology; Vitamins