急性泪囊炎作为小儿白血病的首发症状
Acute dacryocystitis as a presenting sign of pediatric leukemia.
作者信息
Wirostko W J, Garcia G H, Cory S, Harris G J
机构信息
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.
出版信息
Am J Ophthalmol. 1999 Jun;127(6):734-6. doi: 10.1016/s0002-9394(99)00023-9.
PURPOSE
To report acute dacryocystitis with preseptal cellulitis as the presenting sign of leukemia in a child.
METHODS
Case report and literature review.
RESULTS
During the initial evaluation of a 17-month-old child with epiphora, left lower eyelid swelling, and a tender left medial canthal mass, a complete blood cell count demonstrated pancytopenia. Bone marrow biopsy disclosed replacement of normal cellular architecture with a dense infiltrate of leukocyte blast forms. DNA analysis disclosed a translocation between chromosome 10 and 11, consistent with the diagnosis of nonlymphocytic leukemia. Although the adjacent lower eyelid cellulitis responded to intravenous antibiotics, lacrimal sac distention decreased only after chemotherapy was initiated.
CONCLUSIONS
Dacryocystitis with preseptal cellulitis can be a presenting sign of leukemia. This blood malignancy should be considered in patients whose leukocyte counts do not correlate with their clinical presentation.
目的
报告1例以急性泪囊炎合并眶隔前蜂窝织炎为首发症状的儿童白血病。
方法
病例报告及文献复习。
结果
对一名17个月大、有溢泪、左下睑肿胀及左内眦部压痛性肿块的患儿进行初步评估时，全血细胞计数显示全血细胞减少。骨髓活检显示正常细胞结构被白细胞原始细胞密集浸润所取代。DNA分析显示10号和11号染色体之间存在易位，符合非淋巴细胞白血病的诊断。尽管相邻的下睑蜂窝织炎对静脉使用抗生素有反应，但仅在开始化疗后泪囊扩张才有所减轻。
结论
泪囊炎合并眶隔前蜂窝织炎可能是白血病的首发症状。对于白细胞计数与临床表现不相符的患者，应考虑这种血液恶性肿瘤。
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