双侧脉络膜浸润作为华氏巨球蛋白血症复发的初始表现
Bilateral Choroidal Infiltrates as the Initial Manifestation of Waldenström Macroglobulinemia Relapse.
作者信息
Tan Jason, Chandra Varun, Hall Anthony J
机构信息
Department of Ophthalmology, Alfred Health, Melbourne, VIC, Australia.
出版信息
J Vitreoretin Dis. 2021 Jul 1;6(2):158-162. doi: 10.1177/24741264211021238. eCollection 2022 Mar-Apr.
PURPOSE
This work describes a case of Waldenström macroglobulinemia (WM) relapse presenting with unilateral blurred vision.
METHOD
A case report is presented.
RESULTS
A 60-year-old woman with a history of WM in remission was referred for suspicious peripheral choroidal lesions and left optic disc swelling. Magnetic resonance imaging revealed optic nerve and cranial nerve infiltration consistent with central nervous system invasion from WM relapse, called Bing-Neel syndrome. Irradiation of the optic nerve and systemic targeted therapy were successful in addressing the ocular features as well as reducing immunoglobulin M paraprotein levels and lymphoproliferative disease burden.
CONCLUSIONS
We described the first documented case to our knowledge of intraocular involvement as the earliest sign of relapse of WM. Ophthalmology assessment is warranted in patients with a history of WM who present with new ocular symptoms to aid early detection and treatment of this disease.
目的
本研究描述了1例以单侧视力模糊为表现的华氏巨球蛋白血症（WM）复发病例。
方法
本文报告1例病例。
结果
1名有WM缓解病史的60岁女性因可疑的周边脉络膜病变和左侧视盘肿胀前来就诊。磁共振成像显示视神经和颅神经浸润，符合WM复发所致的中枢神经系统侵犯，即宾-尼尔综合征。对视神经进行放疗及全身靶向治疗成功改善了眼部症状，同时降低了免疫球蛋白M副蛋白水平和淋巴增殖性疾病负担。
结论
据我们所知，我们描述了首例有文献记载的以眼内受累作为WM复发最早体征的病例。有WM病史且出现新的眼部症状的患者有必要进行眼科评估，以助于该病的早期发现和治疗。
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