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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Paulus Budiono Notopuro
Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Sudden Death Due to Intracranial Hemorrhage Caused by Acute Promyelocytic Leukemia Nur Chumairoh; Khoiruman Khoirulwaro; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 2 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i2.2392

Abstract

Intracranial hemorrhage (ICH) is one of the complications that causes early death in the diagnosis of acute promyelocytic leukemia (APL). Bone marrow failure in APL due to platelet dysfunction significantly increases the risk of bleeding complications. This case report discusses the case of a male patient who presented with the main complaint of seizures, accompanied by ICH radiological images and peripheral blood smears, leading to APL, and who died in a short time. A 58-year-old male presented to the emergency room with complaints of seizures. The patient denied the presence of trauma, fever, chills, headache, or abdominal pain. On physical examination, the temperature was 36.5°C, pulse rate 85 times/minute, respiratory rate 20 times/minute, and 115/78 mmHg blood pressure, no patches on the skin, and no inflammation in the joints. An initial laboratory examination was performed, and the results revealed hemoglobin level 11.6 g/dL, platelet count 51,000/μL, and leukocyte count 95,890/μL. Radiological examination was performed, and there was bleeding in the cortical-subcortical left parietal lobe and brain edema, leading to intracranial hemorrhage (ICH). The peripheral blood smears showed 78% bilobed, cup-like blast and promyelocytic images, and immunophenotyping CD33, CD13, MPO, and CD117 results were positive. Patients with clinical symptoms showing signs of cerebral hemorrhage, with hematology laboratory results (hyperleukocytosis), should be taken heed as one of the complications due to acute promyelocytic leukemia.
Co-Authors Arifoel Hajat Khoiruman Khoirulwaro Nur Chumairoh