Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse
Objective: Unilateral ocular leukemic infiltration with acute angle closure is an infrequent complication of B-cell acute lymphoblastic leukemia (ALL-B). We present a clinical case of leukemic ocular infiltration as the sole manifestation of ALL-B relapse.Methods: Case descriptionResults: A 15-year-...
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| Format: | Article |
| Language: | English |
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German Medical Science GMS Publishing House
2019-04-01
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| Series: | GMS Ophthalmology Cases |
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| Online Access: | http://www.egms.de/static/en/journals/oc/2019-9/oc000105.shtml |
| _version_ | 1818108345341444096 |
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| author | Silva, Diana Mota, Mafalda Bilé, Andreia Ramalho, Mário Pinto, Sara Pires, Graça Teixeira, Susana Prieto, Isabel |
| author_facet | Silva, Diana Mota, Mafalda Bilé, Andreia Ramalho, Mário Pinto, Sara Pires, Graça Teixeira, Susana Prieto, Isabel |
| author_sort | Silva, Diana |
| collection | DOAJ |
| description | Objective: Unilateral ocular leukemic infiltration with acute angle closure is an infrequent complication of B-cell acute lymphoblastic leukemia (ALL-B). We present a clinical case of leukemic ocular infiltration as the sole manifestation of ALL-B relapse.Methods: Case descriptionResults: A 15-year-old female with a history of acute lymphoblastic kemia in remission for 2 years and pulmonary tuberculosis treated in the past year presented with ocular redness and decreased visual acuity in the left eye (LE) with 5 days of evolution. Visual acuity was 20/20 in the right eye (RE) and absence of light perception in the left eye (LE). Biomicroscopy of LE showed a small hypopion, anterior chamber cells 4+, vitreous cells 3+, and a large white mass in the vitreous with associated vitreous hemorrhage in organization. In LE fundoscopy, the vitreous mass occupying most of the vitreous cavity and associated hemorrhage prevented retina visualization. B-scan sound showed a multilobulated mass occupying virtually the entire vitreous cavity with associated choroidal detachment. Forty-eight hours later, she developed acute angle closure of LE with an IOP of 55 mmHg. A flow cytometric analysis of the anterior chamber and vitreous showed leukemic tumor cells. The microbiologic exam and PCR for were negative. No other signs of relapse of the disease were identified after investigation by the oncology department. Rescue treatment of the underlying disease was started, with symptomatic improvement. Conclusion: Leukemic ocular infiltration can be the only manifestation of ALL-B relapse. |
| first_indexed | 2024-12-11T02:13:53Z |
| format | Article |
| id | doaj.art-09f49d06c1aa49378d8d6df7e2247536 |
| institution | Directory Open Access Journal |
| issn | 2193-1496 |
| language | English |
| last_indexed | 2024-12-11T02:13:53Z |
| publishDate | 2019-04-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS Ophthalmology Cases |
| spelling | doaj.art-09f49d06c1aa49378d8d6df7e22475362022-12-22T01:24:13ZengGerman Medical Science GMS Publishing HouseGMS Ophthalmology Cases2193-14962019-04-019Doc1610.3205/oc000105Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapseSilva, Diana0Mota, Mafalda1Bilé, Andreia2Ramalho, Mário3Pinto, Sara4Pires, Graça5Teixeira, Susana6Prieto, Isabel7Hospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Pediatric Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalHospital Prof. Dr. Fernando Fonseca E.P.E., Ophthalmology Department, Amadora-Sintra, PortugalObjective: Unilateral ocular leukemic infiltration with acute angle closure is an infrequent complication of B-cell acute lymphoblastic leukemia (ALL-B). We present a clinical case of leukemic ocular infiltration as the sole manifestation of ALL-B relapse.Methods: Case descriptionResults: A 15-year-old female with a history of acute lymphoblastic kemia in remission for 2 years and pulmonary tuberculosis treated in the past year presented with ocular redness and decreased visual acuity in the left eye (LE) with 5 days of evolution. Visual acuity was 20/20 in the right eye (RE) and absence of light perception in the left eye (LE). Biomicroscopy of LE showed a small hypopion, anterior chamber cells 4+, vitreous cells 3+, and a large white mass in the vitreous with associated vitreous hemorrhage in organization. In LE fundoscopy, the vitreous mass occupying most of the vitreous cavity and associated hemorrhage prevented retina visualization. B-scan sound showed a multilobulated mass occupying virtually the entire vitreous cavity with associated choroidal detachment. Forty-eight hours later, she developed acute angle closure of LE with an IOP of 55 mmHg. A flow cytometric analysis of the anterior chamber and vitreous showed leukemic tumor cells. The microbiologic exam and PCR for were negative. No other signs of relapse of the disease were identified after investigation by the oncology department. Rescue treatment of the underlying disease was started, with symptomatic improvement. Conclusion: Leukemic ocular infiltration can be the only manifestation of ALL-B relapse.http://www.egms.de/static/en/journals/oc/2019-9/oc000105.shtmlacute angle closureB-cell acute lymphoblastic leukemia (ALL-B)ocular infiltrationrelapse |
| spellingShingle | Silva, Diana Mota, Mafalda Bilé, Andreia Ramalho, Mário Pinto, Sara Pires, Graça Teixeira, Susana Prieto, Isabel Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse GMS Ophthalmology Cases acute angle closure B-cell acute lymphoblastic leukemia (ALL-B) ocular infiltration relapse |
| title | Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse |
| title_full | Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse |
| title_fullStr | Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse |
| title_full_unstemmed | Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse |
| title_short | Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse |
| title_sort | unilateral leukemic infiltration and acute angle closure as the first sign of b cell acute lymphoblastic leukemia relapse |
| topic | acute angle closure B-cell acute lymphoblastic leukemia (ALL-B) ocular infiltration relapse |
| url | http://www.egms.de/static/en/journals/oc/2019-9/oc000105.shtml |
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