2018
DOI: 10.1155/2018/8201917
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Cardiac Tamponade as the Initial Presentation of Acute Myeloid Leukemia: A Case Report with Review of the Literature

Abstract: Acute myeloid leukemia (AML) is a complex disease with a variety of presentations. A large pericardial effusion is rare, occurring in less than 0.5% of all patients with AML prior to treatment. A 34-year-old male presented with dyspnea, malaise, and weight loss. On physical exam, he was noted to be hypoxic, tachypneic, tachycardic, and hypotensive. He had cervical lymphadenopathy and jugular venous distention. His WBC count was 110 bil/L with 33% blasts. Bone marrow biopsy confirmed AML with 60% blasts. Leukem… Show more

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Cited by 2 publications
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“…Four more case reports of AML presenting as pericardial tamponade have been published. 12 In all four cases, pericardial fluid cytology yielded leukemic cells. In our case, pericardial fluid cytology was negative for malignant cells, the white blood cell count was minimally elevated, and there was no evidence of monocytic differentiation.…”
Section: Discussionmentioning
confidence: 83%
See 1 more Smart Citation
“…Four more case reports of AML presenting as pericardial tamponade have been published. 12 In all four cases, pericardial fluid cytology yielded leukemic cells. In our case, pericardial fluid cytology was negative for malignant cells, the white blood cell count was minimally elevated, and there was no evidence of monocytic differentiation.…”
Section: Discussionmentioning
confidence: 83%
“…There may be direct malignant infiltration of the pericardium by leukemic cells, leading to effusion. 12 Other proposed mechanisms include bleeding diathesis in the setting of thrombocytopenia, infection due to relative immunodeficiency state in leukemia, and effusions resulting as a side effect of chemotherapy. 3,13 Our patient had negative fungal, acid-fast bacilli, mycobacterial, and bacterial pericardial…”
Section: Discussionmentioning
confidence: 99%
“…In contrast, pericardial effusion can occur in 21% of patients with AML at initial diagnosis, but only 0.5% manifests as pericardial tamponade, [ 29 ] a condition for which only 4 documented cases can be found. [ 30 33 ] The average age of these 4 patients was 42 years (range, 28–73 years), of whom 3 were male and 1 was female. 2 of 4 patients died prior to any possible treatment.…”
Section: Discussionmentioning
confidence: 99%