Joshua Lucas and Abhijith Bathini are from Drexel University College of Medicine, 2900 W Queen Ln, Philadelphia, PA 19129, USA.
Dr. Greenberg is from Global Neurosciences Institute, One Medical Center, Blvd ACP 232, Upland, PA 19103, USA.
Am J Emerg Med. 2021 Nov;49:441.e1-441.e2. doi: 10.1016/j.ajem.2021.04.086. Epub 2021 May 1.
Acute myeloid leukemia (AML) accounts for 16% of all leukemias in children. Prognosis in the pediatric population is better than that of older populations, with a younger age at diagnosis being a favorable prognostic factor [1]. Diplopia is a rare first presenting sign of AML. We present a 15 year old male complaining of diplopia and unilateral orbital swelling. Workup in the emergency department found normal neuroimaging but revealed a markedly elevated leukocytosis with anemia and thrombocytopenia. Peripheral smear showed increased blast cells >10%. This patient was ultimately diagnosed with AML. This case demonstrates an atypical presentation of AML and urges a thorough work up for patients presenting with unexplained diplopia.
急性髓细胞白血病（AML）占儿童所有白血病的 16%。儿科患者的预后优于老年患者，诊断时年龄较小是有利的预后因素[1]。复视是 AML 的罕见首发症状。我们报告了一例 15 岁男性，主诉复视和单侧眼眶肿胀。急诊室的检查发现神经影像学正常，但白细胞显著升高，伴有贫血和血小板减少。外周血涂片显示原始细胞增多>10%。该患者最终被诊断为 AML。本病例提示 AML 表现不典型，对于出现不明原因复视的患者，应进行全面检查。
