Hypopyon‐an early sign of leukaemic relapse

Abstract

A 5-year-old girl with ALL developed leukaemic hypopyon after 33 months of treatment. Bone marrow and CNS relapse developed 3 months later, which was successfully treated. Local radiotherapy did not prevent an ocular relapse 2 months later, and a second course of irradiation was successfully given. She developed a second bone marrow relapse and died about 9 months after hypopyon was first identified. It is postulated that hypopyon may be an early sign of leukaemic relapse.

Hypopyon in acute lymphoblastic leukemia

“…As demonstrated by our case, topical treatment for leukemic hypopyon is generally ineffective [3,[5][6][7][8][9][10]. Radiation therapy at doses from 325 to 2,000 rads offered permanent control with the exception of one case.…”

“…This patient received 350 rads to the eye over 5 days and was found to have red eye with cells in the anterior chamber on slit-lamp examination but no hypopyon 2 months later 161. A second course of radiotherapy (500 rads) successfully cleared the cells from the anterior chamber [6].…”

“…Hypopyon has been found in patients with lymphoma [ 11, acute monoblastic leukemia [ 111, and acute myelocytic leukemia [12]. However, the majority of the reported cases has been in patients with acute lymphoblastic leukemia [3], especially in children [2,[4][5][6][7][8][9][10]. It is frequently associated with leukemic involvement of the central nervous system at the same time [4-61 or with previous history of central nervous system leukemia [4,7].…”

Aspectos epidemiológicos, biotipologia e evolução do tratamento da leucemia linfocítica aguda na infância e adolescência no Rio Grande do Sul

“…Nestes casos pode estar envolvido o mesmo clone de células responsável pelas duas formas de apresentação clínica [94][95][96][97][98] . 165 .…”

“…Tanto o comprometimento da câmara anterior como do globo ocular podem ser observados. Na câmara anterior, incluindo o envolvimento da íris, pode se manifestar sob a forma de hipopion e ou hifema 98,[254][255][256][257] .…”