- 期刊
- OpenAccess
Acute Vision Loss as the Initial Presenting Feature of Acute Myeloid Leukemia in a Young Man
以急性視力喪失為初期表現之急性骨髓性白血病—病例報告
摘要
目的：描述一個年輕男性的急性骨髓性白血病以急性視力喪失為初期表現。方法：病例報告。結果：25歲年輕男性，本身無內外科病史。左眼突然視力模糊3天至眼科求診，經視力檢查，右眼最佳矯正視力為6／6.7，左眼最佳矯正視力為眼前可見指數。眼底檢查，可見左眼有黃斑部出血及雙眼視網膜後極部有散在性白色中心出血點（羅特氏斑），抽血檢查顯示雙球性血球減少（紅血球計數為1.12 ×10^6／μl，血小板計數為12 × 10^3／μl）。血液抹片顯示骨髓芽母細胞含有棒狀體（Auer rods）。骨髓穿刺切片顯示CD34細胞染色為陽性。急性骨髓性白血病（M2分型）為確定診斷。經化療，羅特氏斑消失且左眼視力恢復至6／30。結論：病患於未診斷出白血病時，如有眼部症狀，初期會至眼科求診。因此，眼科醫師必須謹記於心此病的眼部臨床表現並小心的檢查。
關鍵字
無資料並列摘要
Purpose: To report a case of acute myeloid leukemia with acute vision loss as the initial presenting feature in a young male.Method: A case report.Result: A 25-year-old young man, who has no other significant medical history, experienced sudden blurred vision in the left eye for 3 days. On examination, the best-corrected visual acuity (BCVA) was 6/6.7 in the right eye and counting finger in the left eye. Fundal examination revealed macular hemorrhage in the left eye and multiple white-centered retinal hemorrhages (Roth spots) scattered in the posterior poles of both eyes. Laboratory examinations revealed bicytopenia (red blood cell, 1.12 × 10^6/ l, and platelets, 12 × 10^3/ l). Peripheral blood smear showed blasts with Auer rods. Bone marrow biopsy revealed CD34 positivity. A diagnosis of acute myeloid leukemia M2 was made. After chemotherapy, the Roth spots disappeared and the visual acuity of the left eye recovered to 6/30.Conclusion: Patients with undiagnosed leukemia may initially be referred to an eye clinic. Keeping in mind and careful examinations are necessary.