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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2016

Open Access 01-12-2016 | Case report

Acute compartment syndrome as the initial manifestation of chronic-phase chronic myeloid leukemia: a case report and review of the literature

Authors: Yoshikazu Nagase, Shuji Ueda, Hitomi Matsunaga, Aya Yoshioka, Yoshiyuki Okada, Tomohisa Machida, Keiichi Nakata, Fuka Mima, Risato Takeda, Daisuke Hayashi, Sadaharu Iio, Kohei Okita, Hiroyuki Narahara, Yuichi Yasunaga, Yoshiaki Inui, Sumio Kawata

Published in: Journal of Medical Case Reports | Issue 1/2016

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Abstract

Background

Acute compartment syndrome is an orthopedic emergency requiring urgent fasciotomy to prevent irreversible damage. In hematological malignancies, acute compartment syndrome caused by severe soft tissue bleeding is extremely rare. We present a patient with chronic-phase chronic myeloid leukemia who had acute compartment syndrome caused by severe soft tissue bleeding in her right forearm.

Case presentation

A 72-year-old Japanese woman was referred to our hospital with swelling and pain of her right forearm without a previous history of trauma. She was diagnosed with chronic-phase chronic myeloid leukemia. Extreme thrombocytosis was present, although no evidence of acquired von Willebrand disorder was found. Compartment syndrome caused by soft tissue bleeding was confirmed. An emergency fasciotomy for decompression was conducted. However, sustained postoperative bleeding occurred and required massive red cell concentrate transfusion. As her platelet count decreased by cytoreductive therapy, complete hemostasis was achieved.

Conclusions

Patients with an extremely high platelet count might be at high risk for severe bleeding complications even without acquired von Willebrand disease. For the control of severe bleeding complications in patients with myeloproliferative disorder, the importance of thrombocyte reduction should be recognized.
Literature
1.
Trumble T. Forearm compartment syndrome secondary to leukemic infiltrates. J Hand Surg Am. 1987;12(4):563–5.CrossRefPubMed
2.
Southworth SR, O’Malley NP, Ebraheim NA, Zeff L, Cummings V. Compartment syndrome as a presentation of non-Hodgkin’s lymphoma. J Orthop Trauma. 1990;4(4):470–3.CrossRefPubMed
3.
Veeragandham RS, Paz IB, Nadeemanee A. Compartment syndrome of the leg secondary to leukemic infiltration: a case report and review of the literature. J Surg Oncol. 1994;55(3):198–200. discussion 200–1.CrossRefPubMed
4.
Scheipl S, Leithner A, Radl R, Beham-Schmid C, Ranner G, Linkesch W, et al. Myeloid sarcoma presenting in muscle-tissue of the lower limb: unusual origin of a compartment-syndrome. Am J Clin Oncol. 2007;30(6):658–9.CrossRefPubMed
5.
Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002;100(7):2292–302.CrossRefPubMed
6.
Wehmeier A, Daum I, Jamin H, Schneider W. Incidence and clinical risk factors for bleeding and thrombotic complications in myeloproliferative disorders. A retrospective analysis of 260 patients. Ann Hematol. 1991;63(2):101–6.CrossRefPubMed
7.
Randi ML, Stocco F, Rossi C, Tison T, Girolami A. Thrombosis and hemorrhage in thrombocytosis: evaluation of a large cohort of patients (357 cases). J Med. 1991;22(4–5):213–23.PubMed
8.
Buss DH, Stuart JJ, Lipscomb GE. The incidence of thrombotic and hemorrhagic disorders in association with extreme thrombocytosis: an analysis of 129 cases. Am J Hematol. 1985;20(4):365–72.CrossRefPubMed
9.
Teng CJ, Huang CT, Huang YC, Hong YC, Wang WS, Tzeng CH. Too many platelets to cause compartment syndrome. QJM. 2011;104(11):993–4.CrossRefPubMed
10.
Ng AP, Servadei P, Tuckfield A, Friedhuber A, Grigg A. Resolution of platelet function defects with imatinib therapy in a patient with chronic myeloid leukaemia in chronic phase. Blood Coagul Fibrinolysis. 2009;20(1):81–3.CrossRefPubMed
11.
van Genderen PJ, Michiels JJ. Erythromelalgic, thrombotic and haemorrhagic manifestations of thrombocythaemia. Presse Med. 1994;23(2):73–7.PubMed
12.
Michiels JJ, Berneman Z, Schroyens W, Finazzi G, Budde U, van Vliet HH. The paradox of platelet activation and impaired function: platelet-von Willebrand factor interactions, and the etiology of thrombotic and hemorrhagic manifestations in essential thrombocythemia and polycythemia vera. Semin Thromb Hemost. 2006;32(6):589–604.CrossRefPubMed
13.
Landolfi R, Marchioli R, Patrono C. Mechanisms of bleeding and thrombosis in myeloproliferative disorders. Thromb Haemost. 1997;78(1):617–21.PubMed
14.
McMahon B, Stein BL. Thrombotic and bleeding complications in classical myeloproliferative neoplasms. Semin Thromb Hemost. 2013;39(1):101–11.PubMed
15.
Michiels JJ. Acquired von Willebrand disease due to increasing platelet count can readily explain the paradox of thrombosis and bleeding in thrombocythemia. Clin Appl Thromb Hemost. 1999;5(3):147–51.CrossRefPubMed
16.
Baker RI, Manoharan A. Platelet function in myeloproliferative disorders: characterization and sequential studies show multiple platelet abnormalities, and change with time. Eur J Haematol. 1988;40(3):267–72.CrossRefPubMed
17.
Manoharan A, Gemmell R, Brighton T, Dunkley S, Lopez K, Kyle P. Thrombosis and bleeding in myeloproliferative disorders: identification of at-risk patients with whole blood platelet aggregation studies. Br J Haematol. 1999;105(3):618–25.CrossRefPubMed
18.
Finazzi G, Budde U, Michiels JJ. Bleeding time and platelet function in essential thrombocythemia and other myeloproliferative syndromes. Leuk Lymphoma. 1996;22 Suppl 1:71–8.CrossRefPubMed
19.
Orlin JB, Berkman EM. Improvement of platelet function following plateletpheresis in patients with myeloproliferative diseases. Transfusion. 1980;20(5):540–5.CrossRefPubMed
20.
Cohen E, Trunzter J, Klinge S, Schwartz K, Schiller J. Acute pediatric leg compartment syndrome in chronic myeloid leukemia. Orthopedics. 2014;37(11):e1036–9.CrossRefPubMed
Metadata
Title
Acute compartment syndrome as the initial manifestation of chronic-phase chronic myeloid leukemia: a case report and review of the literature
Authors
Yoshikazu Nagase
Shuji Ueda
Hitomi Matsunaga
Aya Yoshioka
Yoshiyuki Okada
Tomohisa Machida
Keiichi Nakata
Fuka Mima
Risato Takeda
Daisuke Hayashi
Sadaharu Iio
Kohei Okita
Hiroyuki Narahara
Yuichi Yasunaga
Yoshiaki Inui
Sumio Kawata
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2016
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-016-0985-5

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