{"pk":735,"title":"Disseminated Intravascular Coagulation with Purpura Fulminans Presentation of Acute Promyelocytic Leukemia","subtitle":null,"abstract":"A 47-year-old male presented to the emergency department with 12 hours of nausea, vomiting, abdominal pain, and a widespread skin eruption with mottled, irregular, purpuric lesions with subsequent rapid decompensation. Laboratory analysis revealed thrombocytopenia, bandemia, elevated metamyelocytes, abnormal coagulation panel, decreased fibrinogen, elevated fibrin split products, renal dysfunction, bacterial rods, dohle bodies, and toxic granulation. Acute promyelocytic leukemia (APML) was confirmed via bone marrow biopsy, flow cytometry, and fluorescence in situ hybridization analysis. Disseminated intravascular coagulation (DIC) may be the initial presentation of APML. When treated promptly, APML can achieve high remission rates; however, conditions such as DIC continue to increase mortality requiring early recognition to improve survival rates.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5rz1t8qg","frozenauthors":[{"first_name":"Douglas","middle_name":"","last_name":"Ader","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"},{"first_name":"Muhammad","middle_name":"","last_name":"Durrani","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"},{"first_name":"Eric","middle_name":"","last_name":"Blazar","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"}],"date_submitted":"2019-10-15T04:33:29+03:00","date_accepted":"2019-10-15T04:33:29+03:00","date_published":"2019-10-15T04:34:09+03:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/735/galley/490/download/"}]}