Lethal limb ischaemia in leukaemia. Case report and review of the literature.

Several disturbances of the coagulation system are associated with malignancies of the hematopoietic system. The primary mechanisms of these are disseminated intravascular coagulation and hyperviscosity. As such, bleeding or thrombotic events are often encountered and, occasionally, they may even be the inaugural symptom of leukaemia. The lack of a diagnostic tool that would enable a rapid diagnosis of a hematopoietic malignancy, which may present initially as, for example, a coagulation disorder (arterial or venous thrombotic event and/or haemorrhage), can have dramatic consequences. The treatment of choice for this clinical condition is chemotherapy associated with leukopheresis with the aim of obtaining a rapid cytoreduction. We report here a case relevant to this situation and attempt to assess current knowledge on the ethiopathogenesis and treatment of coagulation abnormalities in leukaemia. Our report highlights the imperative need for immediate haematological diagnosis despite the non-specific presentation.