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Primary Sjögren Syndrome — RACP Adult Medicine MCQ

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HardRheumatologyPrimary Sjögren SyndromeRACP Adult Medicine

A patient treated for APML develops a rising white-cell count without dyspnoea, fever, weight gain, infiltrates, hypotension or organ dysfunction. Which interpretation is most accurate?

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Correct answer: E — It can reflect ATRA/ATO differentiation and requires close syndrome monitoring

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

C is correct. A rising WCC after ATRA/ATO can reflect differentiation and should prompt close monitoring/prophylaxis according to protocol; it does not alone reclassify baseline disease risk. A needs clinical and microbiological evidence. B confuses treatment-emergent leucocytosis with presenting risk. D does not establish refractory disease. E ignores a recognised treatment effect.

Reference: eviQ, Acute promyelocytic leukaemia differentiation syndrome: https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/1752-acute-promyelocytic-leukaemia-differentiation