A patient, on treatment for leukemia, develops the pain, pulmonary infiltrates and pleural effusion. The cause is -

Tretinoin, also known as all-trans retinoic acid (ATRA), is medication used for the treatment of acne and acute promyelocytic leukemia.For acne, it is applied to the skin as a cream or ointment.For leukemia, it is taken by mouth for up to three months Common side effects when used by mouth include shoness of breath, headache, numbness, depression, skin dryness, itchiness, hair loss, vomiting, muscle pains, and vision changes.Other severe side effects include high white blood cell counts and blood clots.When used as a cream, side effects include skin redness, peeling, and sun sensitivity.Use during pregnancy is contraindicated due to the risk of bih defects. It is in the retinoid family of medications Leukemia Tretinoin is used to induce remission in people with acute promyelocytic leukemia who have a mutation (the t(15;17) translocation 160 and/or the presence of the PML/RARa gene) and who don't respond to anthracyclines or can't take that class of drug. It is not used for maintenance therapy. By mouth, this drug is pregnancy category D and should not be used by pregnant women as it may harm the fetus Ref Davidson 23rd edition pg 789