Published: 2021-09-22

A case of acute limb ischemia

Kshiti Rai, K. G. Sajeeth Kumar, Danish Ekkalayil, Anoop Chanthu K. K.


Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.


Acute myeloid leukaemia, Deep vein thrombosis, Leukocytosis, Peripheral arterial occlusive disease

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Bewersdorf JP, Zeiden AM. Hyperleukocytosis and leukostasis in acute myeloid leukemia: can a better understanding of the underlying molecular pathophysiology lead to novel treatments? Cells. 2020;9(10):2310.

Ali AM, Mirrakhimo AE, Abboud CN, Cashen AF. Leukostasis in adult acute hyperleukocytic leukemia: a clinician’s digest. Haematol Oncol. 2016;34(2):69-78.

Creutzig U, Ritter J, Budde M, Sutor A, Schellong G. Early deaths due to hemorrhage and leukostasis in childhood acute myelogenous leukemia. Associations with hyperleukocytosis and acute monocytic leukemia. Cancer. 1987;60(12):3071-9.

Liang H, Ba M, Li C, Li H, Guo Z, He P, et al. A case of acute myelogenous leukemia characterized by arterial and venous thrombosis. Cardiovasc Diagn Ther. 2020;10(5):1332-40.

Hess CJ, Ameziane N, Schuurhuis GJ. Hypermethylation of FANCC and FANCL promoter regions in sporadic acute leukemia. Cell Oncol. 2008;30(4):299-306.

DeStefano V, SorĂ  F, Rossi E, Chiusolo P, Laurenti L, Fianchi L, et al. The risk of thrombosis in patients with acute leukemia: Occurrence of thrombosis at diagnosis and during treatment. J Thromb Haemost. 2005;3(9):1985-92.

Chong BH, Lee SH. Management of thromboembolism in hematologic malignancies. Semin Thromb Hemost. 2007;33(4):435-48.

Singh NK, Sangwan G. Low platelet counts in cancer patients: Should heparin for venous thromboembolism prophylaxis be instituted? J Clin Oncol. 2008;26(11):1906.