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一名急性髓性白血病患者的双侧前巩膜炎和后巩膜炎。

Bilateral anterior and posterior scleritis in a patient with acute myelogenous leukemia.

作者信息

Patel Pujan R, Farrell Maureen C, Peshtani Ani, Berkenstock Meghan K

机构信息

Drexel University College of Medicine, Philadelphia, PA, USA.

Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.

出版信息

Am J Ophthalmol Case Rep. 2022 Mar 24;26:101497. doi: 10.1016/j.ajoc.2022.101497. eCollection 2022 Jun.

Abstract

PURPOSE

To report a novel case of bilateral anterior and posterior scleritis in a patient with acute myelogenous leukemia (AML).

OBSERVATIONS

A 69-year-old African American man was admitted to the hospital for relapse of AML. After admission, but prior to induction of chemotherapy, the patient developed ocular redness and proptosis. The diagnosis of bilateral anterior and posterior scleritis was made following an ophthalmic examination, infectious and autoimmune lab work-up, and neuroimaging. The patient was administered immunosuppressive therapy, clinically monitored, and initiated on chemotherapy for AML relapse. About one week later, the patient showed clinical improvement and resolution of the scleritis and proptosis.

CONCLUSION

Scleritis may present during AML relapse, and it may be due to a paraneoplastic syndrome or a reactive anti-leukemic inflammatory response. Clinicians should monitor patients with AML relapse for symptoms such as ocular redness, proptosis, pain, photophobia, and decreased vision, which may indicate development of scleritis.

摘要

目的

报告1例急性髓系白血病(AML)患者发生双侧前巩膜炎和后巩膜炎的罕见病例。

观察结果

一名69岁的非裔美国男性因AML复发入院。入院后,但在诱导化疗之前,患者出现眼红和眼球突出。经过眼科检查、感染性和自身免疫性实验室检查以及神经影像学检查后,确诊为双侧前巩膜炎和后巩膜炎。患者接受了免疫抑制治疗,进行了临床监测,并开始针对AML复发进行化疗。大约一周后,患者的巩膜炎和眼球突出症状出现临床改善并消退。

结论

巩膜炎可能在AML复发期间出现,可能是由于副肿瘤综合征或反应性抗白血病炎症反应所致。临床医生应监测AML复发患者是否出现眼红、眼球突出、疼痛、畏光和视力下降等症状,这些症状可能提示巩膜炎的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e605/8971595/b411a5d94fae/gr1.jpg

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