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[18个月血液学缓解后急性淋巴细胞白血病患儿出现的眼部定位表现]

[Ocular localization appearing in a child with acute lymphoblastosis after hematological remission for 18 months].

作者信息

Dossa D, Arnaud B, Weil M, Navarro M, Bonnet H, Haye C, Jean R

出版信息

Nouv Rev Fr Hematol (1978). 1978 Apr 14;20(1):41-8.

PMID:276848
Abstract

Case report of a 4-year-old girl in whom a unilateral ocular localization appeared after 1 1/2 year of maintained remission of acute lymphoblastic leukaemia. The evolution of this localization can be divided in three phases: 1. During the first 17 months, an apparent simple relapsing conjunctivitis of the left eye. 2. During the following 5 months, repeated episodes of the left iritis with mydriasis and discolouration of the iris. 3. Finally, left uveitis involving the anterior chamber, with hypopion, hyphaema and glaucoma; the clinical presentation at this stage was suggestive of ocular lymphoblastosis. Radiotherapy to the lesion (total dose, 1 200 rads) was quickly followed by resolution without sequelae. No relapse was observed during the following 30 months, till death. The ocular disease remained the only manifestation of leukaemia during its evolution. A haematological relapse occurred 11 months after cure of the iritis, followed 1 year later by a second, treatment-sensitive relapse, and finally by a third, fatal relapse. The patient survived 5 years 9 months.

摘要

一名4岁女孩的病例报告,该女孩在急性淋巴细胞白血病维持缓解1年半后出现单侧眼部病变。此病变的发展可分为三个阶段:1. 在最初的17个月里,左眼出现明显的单纯复发性结膜炎。2. 在接下来的5个月里,左眼反复出现虹膜炎,伴有瞳孔散大和虹膜变色。3. 最后,左眼葡萄膜炎累及前房,伴有前房积脓、前房出血和青光眼;此阶段的临床表现提示眼部淋巴母细胞增多症。对病变进行放射治疗(总剂量1200拉德)后,病变迅速消退且无后遗症。在随后的30个月直至死亡期间,未观察到复发。眼部疾病在其发展过程中一直是白血病的唯一表现。虹膜炎治愈11个月后发生血液学复发,1年后出现第二次对治疗敏感的复发,最后出现第三次致命复发。患者存活了5年9个月。

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