Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management

Table 2

The Naranjo Adverse Drug Reaction Probability Scale [9].

		Yes	No	Do not know	Score
1	Are there previous conclusive reports on this reaction?				+1
2	Did the adverse event occur after the suspected drug was administered?				+2
3	Did the adverse reaction improve when the drug was discontinued?				+1
4	Did the adverse reaction reappear when the drug was readministered?				0
5	Are there alternative causes (other than the drug) that could have on their own caused the reaction?				+2
6	Did the reaction reappear when a placebo was given?				—
7	Was the drug detected in the blood (or other fluids) in a concentration known to be toxic?				—
8	Was the reaction more severe when the dose was increased or less severe when the dose was decreased?				—
9	Did the patient have a similar reaction to the same or similar drugs in any previous exposure?				—
10	Was the adverse event confirmed by any objective evidence?				+1
Total score					7
This is a probable adverse effect of ATRA

She was not rechallenged with ATRA in order to avoid recurrence of drug induced cardiotoxicity which might be life-threatening.