Undiagnosed, Untreated Acute Promyelocytic Leukemia Presenting as a Suspicious Sudden Death


  • Presented at the 62nd Annual Meeting of the American Academy of Forensic Sciences in February 22–27, 2010, in Seattle, WA.

Additional Information and reprint requests:
Pauline Saint-Martin, M.D.
Service de Médecine Légale
Centre Hospitalier Régional Universitaire de Tours
37044 TOURS Cedex 9
E-mail: p.saint-martin@chu-tours.fr


Abstract:  Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia frequently associated with clotting abnormalities and severe hemorrhagic diathesis. The disease is associated with a high incidence of early fatal hemorrhage. We report the sudden death of a 40-year-old male without significant medical history in which foul play had been initially suspected. A thorough postmortem investigation performed on the decedent lead to the diagnosis of APL. Cause of death was a cerebellar hematoma. Underlying APL should be considered in the differential diagnosis when unexplained bleeding is encountered in a decedent. This case emphasizes the value of routinely collecting bone marrow during an autopsy to enable accurate testing and diagnosis.