Nonbacterial Thrombotic Endocarditis as a Presenting Paraneoplastic Manifestation of Acute Promyelocytic Leukemia.
Publication/Presentation Date
7-16-2025
Abstract
BACKGROUND: Nonbacterial thrombotic endocarditis (NBTE) is a noninflammatory endocarditis that occurs in hypercoagulable states. Acute promyelocytic leukemia (APL) is an aggressive form of acute leukemia associated with significant coagulopathy.
CASE SUMMARY: A 45-year-old woman with new pulmonary emboli and progressive heart failure developed pancytopenia, leading to diagnosis of APL and cardiogenic shock secondary to NBTE of the mitral valve. APL was treated with induction chemotherapy, alongside inotropic support for cardiogenic shock. After cancer remission, she underwent mitral valve replacement, resolving the cardiogenic shock.
DISCUSSION: NBTE is a recognized complication of solid malignancy but is rarely associated with leukemia. Fewer than 5 cases have been reported in APL. This case highlights 2 critical complications of each disease process: cardiogenic shock and disseminated intravascular coagulation.
TAKE-HOME MESSAGES: APL and NBTE can present as oncologic and cardiac emergencies. Co-managing these conditions requires a multidisciplinary approach integrating specialized care in both cardiology and oncology.
Volume
30
Issue
19
First Page
104043
Last Page
104043
ISSN
2666-0849
Published In/Presented At
Fradin, J. J., Riley, J. M., Storozynsky, E., Tchantchaleishvili, V., & Wilde, L. R. (2025). Nonbacterial Thrombotic Endocarditis as a Presenting Paraneoplastic Manifestation of Acute Promyelocytic Leukemia. JACC. Case reports, 30(19), 104043. https://doi.org/10.1016/j.jaccas.2025.104043
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40681269
Department(s)
Administration and Leadership
Document Type
Article