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; paial thromboplastin time-50 sec; and Fibrinogen 10 mg/dL. Peripheral smear was suggestive of acute myeloblastic leukaemia. Which of the following is the most likely ?
Correct Answer: Promelocytic leukemia.
Description: TEXT BOOK OF PATHOLOGY HARSHMOHAN 6TH EDITION PG NO 363 Thrombocytopenia . The platelet count is usually moderately to severely reduced (below 50,000/ml) but occasionally it may be normal. Bleeding tendencies in AML are usually correlated with the level of thrombocytopenia but most serious spontaneous haemorrhagic episodes develop in patients with fewer than 20,000/ml platelets. Acute promyelocytic leukaemia (M3) may be associated with a serious coagulation abnormality, disseminated intravascular coagulation (DIC)count is usually moderately to severely reduced (below 50,000/ml) but occasionally it may be normal. Bleeding tendencies in AML are usually correlated with the level of thrombocytopenia but most serious spontaneous haemorrhagic episodes develop in patients with fewer than 20,000/ml platelets. Acute promyelocytic leukaemia (M3) may be associated with a serious coagulation abnormality, disseminated intravascular coagulation (DIC) <p>
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