Abstract
The patient, a 39-year-old man, was admitted on August 23, 1976, because of anemia and general fatigue. Peripheral blood examination revealed leukocytosis of 110, 600/cmm. with 86 per cent of peroxidase positive myeloblasts. A diagnosis of AML was made.
On the 10 th hospital day, he was clinically improved following the treatment with daunorubicin, methotrexate and prednisolone. On the 15 th hospital day, leukocyte count rose to 10, 000/cmm. with 35% myeloblasts and 12% promyelocytes. Platelet count decreased to 30, 000/ cmm.. Coagulation studies revealed marked decrease of fibrinogen (20mg/dl), increase of FDP (50μg/ml), prolongation of prothrombin time (15sec., 45%) and the extraordinary reduction of euglobulin lysis time (30min.) . Those were suggestive of the presence of disseminated intravascular coagulation. He was treated again with DCP without clinical responses. On the 25 th hospital day, he had a sudden onset of chest pain, fever and bloody expectoration. A chest film showed diffuse infiltration in the left lower field. An electrocardiogram disclosed no findings of pulmonary infarction. He was expired on September 17, 1976.
On postmortem examination, pulmonary embolus and thrombus adhering to tricuspid valve were found.
Pulmonary embolus might be originated from the thrombus adhering to tricuspid valve caused by disseminated intravascular coagulation.
