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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2017, Vol. 11 Issue (2) : 284-286    https://doi.org/10.1007/s11684-017-0514-y
CASE REPORT
Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient: a case report
Haiyan He, Ran An, Jian Hou, Weijun Fu()
Myeloma and Lymphoma Center, Department of Hematology, Changzheng Hospital, Shanghai 200003, China
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Abstract

Arsenic trioxide (ATO), a component of the traditional Chinese medicine arsenic sublimate, promotes apoptosis and induces leukemic cell differentiation. Combined with all-trans-retinotic acid (ATRA), ATO has become the first-line induction therapy in treating acute promyelocytic leukemia (APL). The most common side effects of ATO include hepatotoxicity, gastrointestinal symptoms, water-sodium retention, and nervous system damage. In this report, we present a rare side effect, rhabdomyolysis, in a 68-year-old female APL patient who was treated with ATO. After taking 10 mg ATO daily for 6 days, she presented shortness of breath, myodynia, elevated creatine kinase, and acute renal insufficiency. This report describes the first case of ATO-induced rhabdomyolysis.

Keywords arsenic trioxide      APL      rhabdomyolysis     
Corresponding Author(s): Weijun Fu   
Just Accepted Date: 16 March 2017   Online First Date: 13 April 2017    Issue Date: 01 June 2017
 Cite this article:   
Haiyan He,Ran An,Jian Hou, et al. Arsenic trioxide induced rhabdomyolysis, a rare but severe side effect, in an APL patient: a case report[J]. Front. Med., 2017, 11(2): 284-286.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0514-y
https://academic.hep.com.cn/fmd/EN/Y2017/V11/I2/284
1st day (ATO plus ?ARTA started)7th day8th day (ATO plus ATRA stopped)9th day10th day11th day21st day ?(3 weeks after ?single ARTA)
WBC (× 103/μl)0.89.78.112.719.824.910.6
Hb (g/L)98928264606081
Platelets ( × 109/L)4026893621203
Creatinine kinase (U/L)160562638150741810420
CK-MM (U/L)14947850713513728214
CK-MB (U/L)118413115646226
Creatinine (μmol/L)70151295239194145105
ALT (U/L)40495540272114
AST (U/L)2645623481401414
Myoglobin (ng/ml)65.5937.551716610543.650.4
LDH (U/L)1103820588531311856833319
cTnT (ng/ml)0.074.0513.75.363.90.190.01
Tab.1  Patient’s biochemistry trend in relation to initiation and cessation of arsenic trioxide
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