LAUSR

A male patient in his 30s was transferred to our tertiary care hospital from a local ED with a primary symptom of progressive shortness of breath. Prior to transfer, the patient was diagnosed with bilateral pulmonary emboli and a right lower lobe infarct on a CT scan of the chest with pulmonary angiography. He received anticoagulation therapy at the outside facility, and this therapy was continued at our institution. Also notable was a leukocyte count of 290,000/mL with 69% blasts. Results of a bone marrow biopsy confirmed M4 subtype acute myeloblastic leukemia, requiring leukapheresis and induction chemotherapy. A lower extremity ultrasound confirmed a left DVT. International normalized ratio on admission was 1.7. The chest roentgenogram (CXR) on admission suggested minimal pleural effusion on the right and no pulmonary congestion.