Bilateral Compartment Syndrome Affecting the Upper Limbs in a Patient With Chronic Myeloid Leukemia

A 70-year-old male patient who had recently been recently diagnosed with chromic myeloid leukemia (CML) presented to the emergency department with bilateral upper limb pain and swelling. Examination of his upper limbs revealed features suggestive of compartment syndrome. Blood investigations demonst...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-11, Vol.16 (11), p.e74104
Main Authors: Varadhan, Abhinav, Bagavandoss, Aswinishree, Edmunds, Christopher T, Oyibo, Samson O
Format: Article
Language:English
Subjects:
Anticoagulants
Blood pressure
Chromosomes
Compartment syndrome
Creatinine
Dehydrogenases
Drug overdose
Emergency medical care
Emergency Medicine
General Surgery
Hematology
Injuries
Kinases
Leukemia
Medical history
Pain
Proteins
Thrombosis
Tomography
Trauma
Ultrasonic imaging
Veins & arteries
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Summary:A 70-year-old male patient who had recently been recently diagnosed with chromic myeloid leukemia (CML) presented to the emergency department with bilateral upper limb pain and swelling. Examination of his upper limbs revealed features suggestive of compartment syndrome. Blood investigations demonstrated anaemia, rhabdomyolysis and renal function impairment. Because of the rapid fall in hemoglobin levels, he required clotting factors and blood product resuscitation. Compartment pressure measurements were elevated, confirming the diagnosis of bilateral acute compartment syndrome secondary to bleeding. Initial investigations demonstrated low factor XIII levels. Once stabilized, he underwent bilateral fasciotomies but required intensive care management post-surgery, including ongoing blood product resuscitation and renal replacement therapy. Levels of factor XIII continued to fall. Although there have been reported cases of acute leukaemia involving factor XIII deficiency, reports of chronic leukaemia involving factor XIII deficiency are rare. This case provides key learning of a known complication of acute leukaemia and highlights a rare surgical complication of factor XIII deficiency.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.74104