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Bilateral Pseudo-hypopyon as Presenting Symptom of Acute Monocytic Leukemia in an 8-Month-Old Infant.
Journal of Pediatric Ophthalmology and Strabismus ( IF 1.0 ) Pub Date : 2021-09-01 , DOI: 10.3928/01913913-20210708-05
Nicholas M. Scoville , Shu Feng , Mallory R. Taylor , Erin Herlihy , Jennifer J. Wilkes , Karen M. Chisholm , Kristina Tarczy-Hornoch

A previously healthy 8-month-old female infant presenting with lethargy and bilateral eye redness and cloudiness had bilateral hypopyon uveitis, which persisted despite topical steroids. Cytology of the anterior chamber and cerebrospinal fluid and flow cytometry of cerebrospinal fluid revealed malignant cells consistent with acute monocytic leukemia. Bone marrow aspirates and biopsies showed no evidence of disease. She was treated with systemic and intrathecal chemotherapy, with subsequent remission and resolution of pseudo-hypopyon. Anterior chamber involvement is a rare presentation of acute myeloid leukemia and may indicate concurrent central nervous system involvement. This has important therapeutic implications, because additional treatment modalities such as intrathecal chemotherapy, local chemotherapy, and ocular radiation may be required to overcome the "pharmacologic sanctuary" created by the blood-ocular barrier. [J Pediatr Ophthalmol Strabismus. 2021;58(5):e30-e33.].

中文翻译:

双侧假性低子宫肌瘤作为 8 个月大婴儿急性单核细胞白血病的症状。

一名先前健康的 8 个月大女婴表现为嗜睡和双侧眼睛发红和混浊,双侧前房积脓葡萄膜炎,尽管局部使用类固醇,但仍持续存在。前房和脑脊液细胞学和脑脊液流式细胞术显示恶性细胞符合急性单核细胞白血病。骨髓穿刺和活检显示没有疾病证据。她接受了全身和鞘内化疗,随后缓解并解决了假性子宫肌瘤。前房受累是急性髓系白血病的罕见表现,可能提示并发中枢神经系统受累。这具有重要的治疗意义,因为额外的治疗方式,如鞘内化疗、局部化疗、可能需要眼部放射来克服由血眼屏障造成的“药理学庇护”。[J Pediatr Ophthalmol 斜视。2021;58(5):e30-e33.]。
更新日期:2021-09-01
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