A 15 year old boy presented with one day history of bleeding gums, subcoujunctival bleed and purpuric rash. Investigations revealed the following results. Hb-6.4 gm/dL; TLC-26,500/mm3, Platelet 35,000/mm3; prothrombin time-20 sec with a control of 13 sec; partial thromboplastin time-50sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?
a) Myeloblastic leukemia without maturation
b) Myeloblastic leukemia with maturation
c) Promyelocytic leukemia
d) Myelomonocytic leukemia
Correct answer : c) Promyelocytic leukemia
The boy is in a state of disseminated intravascular coagulation (Thrombocytopenia, increased Prothrombin time, increased Partial thromboplastin time and decreased Fibrinogen levels). Promyelocytic leukemia is the one most commonly associated with DIC.