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NR 6/2004
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Ostre zapalenie
gałki ocznej u 15-letniego chłopca w przebiegu ostrej białaczki
limfoblastycznej – część I
Acute endophthalmitis of
15-year old boy in the course of acute lymphoblastic leukemia –
part I
Dorota Pojda-Wilczek1, Stefan
M. Pojda1, Barbara Zatorska1, Ewa Herba1,
Wojciech Jędrzejewski1, Anna Janik-Moszant2,
Halina Bubała2
1Z Katedry i Oddziału Klinicznego Okulistyki Śląskiej
Akademii Medycznej w Katowicach, Szpital Specjalistyczny nr 1 w
Bytomiu
Kierownik: prof. dr hab. n. med. Stefan M. Pojda
2Z Katedry i Kliniki Hematologii Dziecięcej i
Chemioterapii Śląskiej Akademii Medycznej w Katowicach
Kierownik: prof. dr hab. n. med. Danuta Sońta-Jakimczyk |
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| Summary: |
Purpose: The aim of
this study is to present dramatic ocular manifestation
of acute limfoblastic leukemia.
Material and methods: 15-year old boy was
hospitalized due to acute leukemia at the Department and
Clinic of Pediatric Hematology and was referred to
ophthalmologist because of strong pain and decreased
visual acuity of the left eye. General ophthalmic
examination and electrophysiology were done. These
procedures were repeated after 1, 2, 5 and 11 weeks and
also after 6 and 9 months.
Results: Acute uveitis with cellular exudation to
the vitreous, papilledema, swelling of the macula and
green-yellowish infiltration which elevated the temporal
part of the retina, were noticed. Swelling of the iris
and miosis were observed. After one week of local
anti-inflammatory treatment the eye became painless with
little deep injection only. Simultaneously causal
treatment of basic disease was continued. Control
examinations revealed step by step improvement of ocular
changes. After 6 months in the place of retinal
infiltration choroidoretinal atrophy was seen. The
functional deficits in visual field and
electrophysiological examinations were found, too. One
year later, the patient came again because of recurrence.
Involvement of the central nervous system with signs of
meningitis occurred. Visual acuity was normal and no
infiltration of eyes was found, but there was
papilledema in both eyes.
Conclusions: In acute leukemia ocular
manifestation may be highly expressed. The patients
require local symptomatic and general causal treatment
in cooperation of ophthalmologist with hematologist. |
| Słowa kluczowe: |
Białaczka ostra
limfoblastyczna, objawy okulistyczne, infiltracja błony
naczyniowej. |
| Key words: |
Acute lymphoblastic
leukemia, ocular signs, choroidal infiltration. |
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