Other
Effect of relapsing polychondritis and leukemic infiltration in a patient with myelodysplastic syndrome
Alen Sekelj
; Department of ENT and Cervicofacial Surgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
Sandra Sekelj
; Department of Ophthalmology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
Davorin Đanić
; Department of ENT and Cervicofacial Surgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
Sanja Mitrović
; Department of Ophthalmology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
Abstract
A 56-year-old female patient with myelodysplastic syndrome is presented, in whom pathogenetically diverse mechanisms led to the development of severe sensorineural hearing loss and bilateral blindness. The patient had suffered from myelodysplastic syndrome from 2003. One year after verification of the diagnosis, she presented to the Department of Ophthalmology for ptosis and edema of the right eyelid, exophthalmia, visual impairment, and restricted ocular movement. The discomforts persisted for four weeks to result in the loss of vision. This was followed by impaired hearing in the right ear, accompanied by vertigo. Two months later, the same occurred in the left ear, preceded by visual impairment in the left eye with identical symptomatology as in the right eye. The disease eventually resulted in bilateral hearing loss and blindness. Laboratory findings were consistent with the clinical picture. Audiologic testing confirmed sensorineural deafness in the right ear first, followed by severe conductive hearing loss in the left ear. Computed tomography and nuclear magnetic resonance findings of the ear were normal. Computed tomography of the orbits showed bilateral optic nerve thickening. There was bilateral absence of visual evoked potentials and presence of relative afferent pupillary defect. Analysis of the patient’s findings and comparison with literature reports suggested the role of two mechanisms, i.e. relapsing polychondritis and leukemic cell infiltration, in the pathogenesis of myelodysplastic syndrome symptomatology.
Keywords
hearing loss; myelodysplastic syndrome; optic nerve atrophy; leukemic infiltration; relapsing polychondritis
Hrčak ID:
280767
URI
Publication date:
22.11.2007.
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