Bilateral Ocular Exophthalmia - A Case of Atypical Acute Myeloblastic Leukemia in a Child

The Journal of Critical Care Medicine
Réka TothMihaela Ioana Chinceșan

Abstract

In acute myeloblastic leukaemia (AML) explosive proliferation and accumulation of immature myeloid cell clones take place, replacing the bone marrow, with the possibility of the formation of extramedullary tumour masses composed of myeloid cells. The onset of the disease less frequently consists of symptoms of extramedullary manifestation. A Caucasian male child aged three years and 11 months was hospitalized for bilateral exophthalmos and otorrhea, due to an alteration in his general condition. Ocular ultrasound revealed an inhomogeneous thickening of the upper right muscles superior to the eyeball. A complete blood count showed severe anaemia, leucocytosis with neutropenia and thrombocytopenia. A peripheral blood smear evidenced myeloblasts. The result of the cytology of bone marrow confirmed the diagnosis of AML. Following blood product replacements and cytostatic treatment (AML-BFM 2004 HR protocol), the remission of exophthalmos and the correction of haematological parameters were favourable. In a child with a sudden onset of exophthalmia and altered general condition, the diagnosis of acute leukaemia should be considered. The importance of performing a peripheral blood smear and bone marrow examination is emphasized so th...Continue Reading

References

Mar 14, 1998·The British Journal of Ophthalmology·F A StocklM N Burnier
Oct 7, 2003·Journal of Pediatric Hematology/oncology·Kathryn E DusenberyWilliam G Woods
Apr 7, 2007·Ophthalmic Plastic and Reconstructive Surgery·Maziar BidarBarrett G Haik
Jan 27, 2009·Journal of Hematology & Oncology·Ramesh MurthyVijayanand Reddy
Jul 29, 2011·Blood·Richard L BakstJoachim Yahalom
Apr 1, 2012·Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society·Imtiaz A ChaudhryHind M Alkatan
Oct 3, 2013·Journal of Clinical and Diagnostic Research : JCDR·Brijesh ThakurSmita Chauhan

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Methods Mentioned

BETA
biopsy
flow cytometry
electrophoresis

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