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Pathophysiology, clinical features and radiological findings of differentiation syndrome/all-trans-retinoic acid syndrome

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World Journal of Radiology 2014年第8期6卷 583-588页

作者： Luciano Cardinale Francesco Asteggiano Federica Moretti Federico Torre Stefano Ulisciani Carmen Fava Giovanna Rege-Cambrin Institute of Radiology Department of Clinical and Biological Sciences University of Turin AOU S.Luigi Gonzaga 10043 Orbassano Torino Italy Division of Hematology and Internal Medicine Department of Clinical and Biological Sciences of University of Turin AOU S.Luigi Gonzaga 10043 Orbassano Torino Italy

In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications.

关键词： differentiation syndrome All-trans-retinoic acid syndrome Chest X-ray and computed tomography Lungleukemic infiltrates Acute promyelocytic leukaemia Promyelocytic leukemia/retinoic acid receptor-α

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A puzzling case of differentiation syndrome mimicking SARS-CoV2 pneumonitis: a case report

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Cancer Advances 2022年第13期5卷 1-3页

作者： B.Namratha Sai Reddy Nishith Vaddeboina Ch.Shyny Reddy Department of Medical Oncology Omega HospitalsHyderabadTelangana 500034India

differentiation syndrome is a complication commonly encountered in acute promyelocytic leukemia patients when treated with Al-Trans retinoic *** differentiation syndrome has veryclose similarities clinically and radiologically to SARS-CoV2 pneumonitis which makes diagnosis of differentiation syndrome challenging specially during this COVID-19 *** hereby report a case of a 68-year-old male with acute promyelocytic leukemia who on initiation of Al-Trans retinoic acid developed acute respiratory distress with radiological findings of multiple ground glass opacities in bilateral lungs suggestive of SARS-CoV2 *** the radiological similarities to differentiation syndrome and on high clinical suspicion,this patient was immediately started on steroids with which he recovered *** this pandemic of SARS-CoV2,distinguishing differentiation syndrome from SARS-CoV2 pneumonitis clinically and radiologically is extremely challenging.

关键词： differentiation syndrome SARS-CoV2 pneumonitis leukemia

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