Priapism as an Initial Manifestation of Chronic Myeloid Leukemia: A Case Report

陰莖異常勃起症是一種泌尿急症，若未及時治療，會造成陰莖海綿體壞死和纖維化而導致勃起功能厚懷。如同許多急症，早期介入治療可有最佳的機會回復功能。低流量的陰莖異常勃起症為白血病罕見的併發症，是由於大量的白血球併白血球留滯而導致高黏稠性所造成的，最常見於慢性骨髓性白血病。在此，我們報告一例二十四歲男性因慢性骨髓性白血病引起的陰莖異常勃起症，用非常高數目的白血球達387800/立方公厘併29%的胚芽細胞來表現。病人因陰莖異常勃起症而由外院轉診至本院急診部就醫。經由系列檢查，包括周邊血液抹片及骨髓抽吸併切片，證實為慢性骨髓性白血病。經由陰莖海綿體抽取血液的緊急處置，陰莖異常勃起獲得緩解。以藥（Imatinib、Allopurlnol及Hydroxyurea）治療，白血球數目於三週後回復正常。本病例提醒急診醫師對於不是因性刺激或性渴望所引起的持續陰莖異常勃起症之病人的診斷和處置之重要性。

關鍵字

慢性骨髓性白血病；白血球增生；白血球留滯；陰莖異常勃起症

並列摘要

Priapism is an urological emergency in which the corpora cavernosa undergoes necrosis and fibrosis that may result in erectile dysfunction, if left untreated. As with many medical emergencies, early intervention allows the best chance for functional recovery. Low-flow priapism is a rare complication of leukemia resulting in hyperviscosity due to high leukocytes with leukostasis and is most frequently found in chronic myeloid leukemia (CML). Herein, we report a case of priapism in a 24-year-old male caused by CML with presentation of very high leukocytes count of 387800/mm^3 and 29% blast cells. He suffered from persistent erection of the penis and was referred to our emergency department by a local clinic. CML was well documented by serial examination, including peripheral blood smear and bone marrow aspiration with biopsy. Emergency management was initiated with aspiration of blood from the corpus cavernosum, and the erection was relieved. Imatinib combined with allopurinol and hydroxyurea was prescribed and the leukocytes count returned to normal range 3 weeks later. This case illustrates the importance of emergency physicians in the diagnosis and management of patients with persistent priapism unrelated to sexual stimulation or desire.

並列關鍵字

chronic myeloid leukemia CML ； leukocytosis ； leukostasis ； priapism

國際替代計量

Priapism as an Initial Manifestation of Chronic Myeloid Leukemia: A Case Report

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