Spontaneous Hemoperitoneum in Chronic Myeloid Leukemia: An Unusual Etiology

Abstract

Spontaneous hemoperitoneum is rare in chronic myeloid leukemia (CML) and is commonly due to splenic hemorrhage which may need surgical intervention. Corpus luteal hemorrhage is common in child bearing women but is rare etiology of spontaneous hemoperitoneum in CML. Conservative approach prevents morbidity associated with CML. Corpus luteal hemorrhage should be considered as possible etiology of spontaneous hemoperitoneum in female patients of chronic myeloid leukemia. A 32-year-old, multiparous woman presented with hypovolemic shock with hemoperitoneum and enlarged spleen and negative urine pregnancy test. She was diagnosed as a case of myeloproliferative disorder as per her hematolgy reports. Initially splenic hemorrhage was thought to be cause of hemoperitoneum but ultrasonography confirmed corpus luteal hemorrhage as the etiological cause. Conservative management was planned which was successful thereby averting surgery. Patient was started on imatinib after diagnoses of chronic myeloid leukemia was established by reverse transcriptase polymerase-chain-reaction testing of peripheral-blood RNA. Also, she conceived while on treatment and delivered healthy baby with her disease being under remission. Corpus luteal hemorrhage is a possible etiology of spontaneous hemoperitoneum in chronic myeloid leukemia in reproductive age group.




doi: http://dx.doi.org/10.4021/jh73e