Budd-chiari syndrome associated with acute promyelocytic leukemia: a case and literature review

Acute promyelocytic leukemia (APL) is prone to hemorrhage and thrombosis during onset and induction treatment. Occasionally, severe and rare thrombosis can occur, which deserves our attention. Such as Budd-Chiari syndrome (BCS). BCS is a rare and severe disease caused by occlusion of the hepatic veins. Ascites, abdominal pain, and abnormal liver function are the first manifestations of this disease. We report the case of a high-risk patient with APL with acute liver failure and massive ascites during induction therapy due to BCS. He was in a critical condition between life-threatening bleeding tendency and thrombosis. The patient was successfully treated with thrombectomy of the right hepatic vein and balloon dilatation therapy, which provided time for APL treatment. Our case highlights an uncommon venous thrombosis due to APL. We hope to provide some new treatment options for clinicians.