Arsenic toxicity manifesting as profuse watery diarrhea during induction therapy for acute promyelocytic leukemia

Ashley Ott; Vinayak Venkataraman; Yousef R Badran; Rose Goldman; Smiljana Spasic; Darshali A Vyas; Philip Amrein; Steven McAfee; Andrew Brunner; Amir T Fathi; Rupa Narayan

doi:10.1002/ccr3.4115

Arsenic toxicity manifesting as profuse watery diarrhea during induction therapy for acute promyelocytic leukemia

Clin Case Rep. 2021 May 15;9(5):e04115. doi: 10.1002/ccr3.4115. eCollection 2021 May.

Authors

Ashley Ott¹, Vinayak Venkataraman¹, Yousef R Badran², Rose Goldman^{3

4}, Smiljana Spasic⁵, Darshali A Vyas¹, Philip Amrein⁶, Steven McAfee⁶, Andrew Brunner⁶, Amir T Fathi⁶, Rupa Narayan⁶

Affiliations

¹ Department of Medicine Massachusetts General Hospital Boston MA USA.
² Division of Gastroenterology Department of Medicine Massachusetts General Hospital Boston MA USA.
³ Department of Environmental Health Harvard T.H. Chan School of Public Health Boston MA USA.
⁴ Department of Medicine Cambridge Health Alliance Boston MA USA.
⁵ Department of Pathology Massachusetts General Hospital Boston MA USA.
⁶ Division of Hematology/Oncology Massachusetts General Hospital Boston MA USA.

Abstract

Arsenic trioxide (ATO) is generally well tolerated for treatment of APL. We present a patient with severe watery diarrhea and pancreatitis thought to be due to ATO toxicity in the setting of obesity and acute kidney injury. Future studies evaluating ATO levels in patients experiencing toxicities may help guide dose modifications.

Keywords: APL; APML; arsenic; diarrhea; obesity; renal insufficiency.

Publication types

Case Reports