Aleukemic Acute Promyelocytic Leukemia: How Concomitant HIV, Hepatitis C, and Chronic Alcohol Use Disorder May Have Hidden an Underlying Malignancy

10 February 2023 : Case report USA

Challenging differential diagnosis, Rare disease, Rare coexistence of disease or pathology

Anas Mahmoud^1ABCDEF, Moutaz Ghrewati^2ADEF, Brooke Kania^1ABDEF*, Minha Naseer^1ABCEF, Ashima Kapoor^2EF, Patrick Michael^1AEF

DOI: 10.12659/AJCR.938086

Am J Case Rep 2023; 24:e938086

Background Case Report Discussion Conclusions References:

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Table 1. Laboratory studies.

Laboratory studies	Values on admission	Values on discharge	Reference range

White blood cell count	1.2×10/mm	4.4×10/mm	4.5–11.0
Red blood cell count	1.89×10/mm	2.5×10/mm	4.33–5.83
Hemoglobin	6.6 g/dL	8.2 g/dL	13.5–17.5
Hematocrit	19.5%	24%	41.0–53.0
Mean corpuscular volume	103.2 fL	96.0 fL	80.0–100.0
Mean corpuscular hemoglobin	34.9 pg	32.8 pg	26.0–32.0
Mean corpuscular hemoglobin concentration	33.8 g/dL	34.2 g/dL	31.0–37.0
Red cell distribution width	21.3%	19.9%	0.5–16.5
Platelet count	45 K/mm	249 K/mm	140–440

Prothrombin time	13.4 seconds		12.2–14.9
International normalized ratio	1.0		N/A
Partial thromboplastin time	28 seconds		21.3–35.1
Fibrinogen level	289 mg/dL		183–503

Iron Level	156 mcg/dL		50–212
Total iron binding capacity	270 mcg/dL		250–450
Iron saturation	58%		15–50
Ferritin level	458 ng/mL		16.4–294
Folate level	11 ng/mL		≥4.1
B12 level	>1500 pg/mL		211–911

B-type natriuretic peptide	587 pg/mL		1–100
Troponin-I	17 pg/mL		3–23

Alcohol level	<10		≤10
U Amphetamine Scr	Negative		Negative
U Barbiturate Scr	Negative		Negative
U Benzodiazapine Scr	Negative		Negative
U THC Scr	Positive		Negative
U Opiate Scr	Positive		Negative
U PCP Scr	Negative		Negative

HIV 1,2 Ag/Ab Combo	548.71 s/co		N/A
HIV 1,2 Index	≥1.00		<1
HIV 1,2 Ag/Ab Interpretation	Reactive		Non-reactive
%CD4 Pos Lymph	54.6%		30.8–58.5
%CD8 Pos Lymph	33.4%		12.0–35.5
Abs CD4 Helper	491/mcL		359–1519
Abs CD8 Suppressor	301/mcL		109–897

HCV Ab	> 11.0 s/co		0.0–0.9
HCV Load	1890000
Hep B Core IgM Ab	Negative		Negative
Hep B Core Total Ab	Positive		Negative
Hep B Surf Ab	Non-reactive		Non-reactive

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