慢性髓性白血病初期表现为双侧视力丧失:病例报告。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2024-09-12 eCollection Date: 2024-10-01 DOI:10.1097/MS9.0000000000002570
Salah Marwan Saadeldine, Yara Mohammad Alammouri
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引用次数: 0

摘要

简介慢性髓性白血病(CML)是成人中最常见的白血病。它可表现出与疾病阶段相关的多种症状和体征。眼部表现是 CML 的首发症状,虽然在疾病的任何阶段都有可能出现,但眼部表现是独一无二的。CML 患者的眼部病变可能没有症状,因此所有患者在最初确诊时都应进行眼部评估:作者报告了一例 17 岁叙利亚男性患者的病例,该患者最初表现为进行性视力下降、疲劳和腹痛。临床检查显示双侧视网膜动脉瘤出血、黄疸和脾脏肿大。骨髓活检结果与 CML 重返 AML 的诊断一致。患者接受了强化化疗,然后准备进行造血移植:讨论:慢性骨髓性白血病可出现多种症状和体征,但眼部表现并不常见。眼部问题的出现可能是由于肿瘤细胞的浸润,也可能是继发性原因,如血小板减少、白细胞增多、高粘滞综合征或白血病栓塞。在文献中,只有一些病例报告称眼睛受累是 CML 的首发表现:尽管这是一种罕见的 CML 表现,但我们认为在处理这些情况时应将其考虑在内,以获得正确的诊断和更好的治疗效果。在决定治疗方法时,血液科医生和眼科医生之间的合作是必要的。急性髓性白血病需要立即就医,其治疗方法与 CML 不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bilateral visual loss as the initial presentation of chronic myeloid leukemia: a case report.

Introduction: Chronic myeloid leukemia (CML) is the most common leukemia in adults. It can present with a wide variable range of symptoms and signs related to the phase of the disease. Ophthalmic manifestations as the first presentation of CML are unique, although they can occur during any stage of the disease. Ocular lesions in CML patients may be asymptomatic, so all patients should undergo an eye evaluation at the initial diagnosis.

Case presentation: The authors report a case of a 17-year-old Syrian male who initially presented with progressive loss of vision, fatigue, and abdominal pain. Clinical examination showed bilateral retinal aneurysm hemorrhage, jaundice, and splenomegaly. Bone marrow biopsy results were consistent with the diagnosis of CML returning to AML. The patient was treated with intensive chemotherapy and then prepared for hematopoietic transplantation.

Discussion: CML can present with variable symptoms and signs, but the ophthalmic manifestations are uncommon. Ophthalmic problems occur either from infiltration of neoplastic cells or from secondary causes, like thrombocytopenia, leukocytosis, hyperviscosity syndrome, or leukoembolization. In the literature, only some case reports presented eye involvement in CML as the first manifestation.

Conclusion: Although this is a rare presentation of CML, we believe that it should be taken into consideration when managing these situations to obtain the right diagnosis and better treatment results. Collaboration between hematologists and ophthalmologists is necessary in deciding the treatment. Acute myeloid leukemia needs immediate medical attention and different treatment from CML.

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Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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