Cargando…
A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with raised granulocyte cell line. It arises in the hematopoietic stem cell and is characterized by the presence of BCR-ABL fusion gene as a result of translocation between chromosomes t(9,22) (q34; q11.2). CML affects bone marrow and p...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768629/ https://www.ncbi.nlm.nih.gov/pubmed/36569729 http://dx.doi.org/10.7759/cureus.31718 |
_version_ | 1784854213405179904 |
---|---|
author | Kandambeth, Varsha Shinde, Pranaykumar Daigavane, Sachin |
author_facet | Kandambeth, Varsha Shinde, Pranaykumar Daigavane, Sachin |
author_sort | Kandambeth, Varsha |
collection | PubMed |
description | Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with raised granulocyte cell line. It arises in the hematopoietic stem cell and is characterized by the presence of BCR-ABL fusion gene as a result of translocation between chromosomes t(9,22) (q34; q11.2). CML affects bone marrow and peripheral blood. CML can be asymptomatic and is usually discovered on routine blood investigations. It can also present as symptoms associated with anemia and splenomegaly. Rarely do CML patients present with retinal abnormalities as an initial presentation. We cover a case of CML in this report that had retinal involvement as one of its earliest manifestations. Patient presented with gradual loss of vision in both eyes. Multiple bilateral intraretinal and preretinal hemorrhages with exudates were found during fundus examination. Blood tests revealed a raised leukocyte count along with lower hemoglobin levels. Peripheral smear revealed 4% blast cells. Bone marrow aspiration showed hypercellular marrow, marked granulocyte proliferation, and raised myeloid erythroid ratio. The diagnosis was further confirmed by fluorescence in-situ hybridization (FISH) which showed BCR-ABL1 fusion gene. Patient was immediately started on chemotherapy and has been on follow-up since then. Visual acuity of the patient improved and there was no progression of retinopathy. This case thus serves as an illustration of how early detection and management can significantly slow the progression of retinopathy and improve visual outcomes. |
format | Online Article Text |
id | pubmed-9768629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-97686292022-12-22 A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy Kandambeth, Varsha Shinde, Pranaykumar Daigavane, Sachin Cureus Ophthalmology Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with raised granulocyte cell line. It arises in the hematopoietic stem cell and is characterized by the presence of BCR-ABL fusion gene as a result of translocation between chromosomes t(9,22) (q34; q11.2). CML affects bone marrow and peripheral blood. CML can be asymptomatic and is usually discovered on routine blood investigations. It can also present as symptoms associated with anemia and splenomegaly. Rarely do CML patients present with retinal abnormalities as an initial presentation. We cover a case of CML in this report that had retinal involvement as one of its earliest manifestations. Patient presented with gradual loss of vision in both eyes. Multiple bilateral intraretinal and preretinal hemorrhages with exudates were found during fundus examination. Blood tests revealed a raised leukocyte count along with lower hemoglobin levels. Peripheral smear revealed 4% blast cells. Bone marrow aspiration showed hypercellular marrow, marked granulocyte proliferation, and raised myeloid erythroid ratio. The diagnosis was further confirmed by fluorescence in-situ hybridization (FISH) which showed BCR-ABL1 fusion gene. Patient was immediately started on chemotherapy and has been on follow-up since then. Visual acuity of the patient improved and there was no progression of retinopathy. This case thus serves as an illustration of how early detection and management can significantly slow the progression of retinopathy and improve visual outcomes. Cureus 2022-11-21 /pmc/articles/PMC9768629/ /pubmed/36569729 http://dx.doi.org/10.7759/cureus.31718 Text en Copyright © 2022, Kandambeth et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Ophthalmology Kandambeth, Varsha Shinde, Pranaykumar Daigavane, Sachin A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title | A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title_full | A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title_fullStr | A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title_full_unstemmed | A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title_short | A Case of Chronic Myeloid Leukemia Presenting as Bilateral Retinopathy |
title_sort | case of chronic myeloid leukemia presenting as bilateral retinopathy |
topic | Ophthalmology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768629/ https://www.ncbi.nlm.nih.gov/pubmed/36569729 http://dx.doi.org/10.7759/cureus.31718 |
work_keys_str_mv | AT kandambethvarsha acaseofchronicmyeloidleukemiapresentingasbilateralretinopathy AT shindepranaykumar acaseofchronicmyeloidleukemiapresentingasbilateralretinopathy AT daigavanesachin acaseofchronicmyeloidleukemiapresentingasbilateralretinopathy AT kandambethvarsha caseofchronicmyeloidleukemiapresentingasbilateralretinopathy AT shindepranaykumar caseofchronicmyeloidleukemiapresentingasbilateralretinopathy AT daigavanesachin caseofchronicmyeloidleukemiapresentingasbilateralretinopathy |