A Case of Acute Sensorineural Hearing Loss as an Initial Manifestation in a Child with Acute Lymphoblastic Leukemia.
- Author:
Young Gyu SONG
1
;
Young Sil PARK
;
Eun Joo CHUN
;
Sun Mi KIM
;
Seung Youn CHUNG
;
Jin Han KANG
;
Hack Ki KIM
;
Dae Chul JEONG
Author Information
1. Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. dcjeong@olmh.cuk.ac.kr
- Publication Type:Case Report
- Keywords:
Sensorineural hearing loss;
Hyperleukocytosis;
Childhood acute lymphoblastic leukemia
- MeSH:
Blood Cell Count;
Blood Platelets;
Brain;
Child*;
Deafness;
Ear;
Ear, Inner;
Hearing;
Hearing Loss;
Hearing Loss, Sensorineural*;
Hematocrit;
Hematuria;
Hemorrhage;
Humans;
Induction Chemotherapy;
Infarction;
Ischemia;
Leukemia;
Leukocytes;
Lymphatic Diseases;
Lymphocytes;
Magnetic Resonance Imaging;
Male;
Monocytes;
Neutrophils;
Oculomotor Nerve Diseases;
Pathology;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*;
Purpura;
Temporal Lobe
- From:Korean Journal of Pediatric Hematology-Oncology
2002;9(2):245-249
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute sensorineural hearing loss is unusual as initial manifestations in a child with acute lymphoblastic leukemia (ALL), even though facial or oculomotor nerve palsy as early finding of leukemia was reported. The pathology of sensorineural hearing loss in leukemia showed as leukemic cell infiltration, hemorrhage, infection, and local ischemia due to hyperviscosity. A 12-year-old boy with ALL was admitted due to multiple cervical lymphadenopathy with left sided sensorineural deafness. He complained gross hematuria and purpura on whole body. His initial complete blood cell counts were hemoglobin 11.9 g/dL, hematocrit 34.3%, white blood cells 164,000/muL (segmented neutrophils 3%, lymphocytes 11%, monocytes 2%, immature blast 84%), and platelet 28,000/muL. Pure tone audiogram revealed profound sensorineural hearing loss of the left ear at all frequencies. His brain MRI showed no definite abnormal findings without hemorrhage or infarction in inner ear or temporal lobe. He received induction chemotherapy and total 4 times of transtympanic steroid injection with 1 week interval. His hearing power at complete remission was more improved than admission, but not completely recovered until 5 months. We proposed that hearing impairment might be an initial manifestation in acute leukemia with hyperleukocytosis.
