A 15-year-old boy presented with one day history of bleeding gums, subconjunctival bleed and purpuric rash. Investigations revealed the following results: Hb-6.4 gm/dL TLC-26,500/mm3; Platelet - 35,000 mm3 Prothrombin time-20 sec with a control of 13 sec Partial thromboplastin time-50 sec and Fibrinogen 10 mg/dl Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?
High-Yield Explanation
The child presented with acute onset of bleeding, along with the following laboratory findings:
Thrombocytopenia (35000/mm3 as compared to normal value of 1,50,000/mm3)
Increased prothrombin time (20s as compared to control of 13s)
Increased partial thromboplastin time (50s vs. normal 26-32s)
Decreased fibrinogen (10 mg/dL vs. normal of 233-496 mg/dl)
These hematological abnormalities indicate disseminated intravascular coagulation.
Most common form of AML associated with DIC is M3-AML (Acute promyelocytic leukemia).