Sudden Bilateral Deafness from Hyperleukocytosis in Chronic Myeloid Leukemia

Abstract

Sudden-onset bilateral deafness as a clinical manifestation of hyperleukocytosis in chronic myeloid leukemia (CML) is a rare occurrence. We found only 27 clinical descriptions in 16 published papers. In this work, the authors present a review on deafness in CML and describe a new case with prominent hyperleukocytosis, where the neurological findings suggest slowing of the circulation through small blood vessels in the brainstem as the cause of deafness. The evolution was good after treatment. To our knowledge, this is the second case documented with electrical auditory brainstem-evoked potentials and the first with magnetic resonance imaging.

Acute Lymphoblastic Leukemia Manifesting as Acute Vogt-Koyanagi-Harada Disease

“…Finally, typical ICGA findings of VKH disease were absent in our case, such as mid-phase multiple hypofluorescent dots in the posterior pole 14. The prodromal symptoms that misdirected the diagnosis may have been caused by leukemic infiltration into the cerebrospinal fluid and microvasculopathy due to hyperleukocytosis 17,18…”

Hearing loss in chronic myeloid leukemia

“…Deafness in CML is described as being sensorineural, unilateral, bilateral or starting as unilateral and progressing to become bilateral. It can be a presenting complaint or develop during the course of the disease 4–8. BERA done in one of the case had shown absence of waves I and III and increased wave I to V interval in another 3,11.…”

“…Various neurological findings are reported in CML including ataxia, nystagmus, papilledema, blindness, non‐response to caloric test, tinnitus, vestibular syndrome, facial palsy, headache, dysarthria and coma, and deafness 3–10. Table I describes the previous cases reported in literature.…”

Use of Laboratory Evaluation and Radiologic Imaging in the Diagnostic Evaluation of Children With Sensorineural Hearing Loss

“… 6,12–17 The HL associated with leukemias is thought to be the result of hyperviscosity or infiltration of the temporal bone interfering with cochlear nerve conduction. 18 Even more rare is the presentation of HL as the initial manifestation of leukemia. We were only able to find one such case report in the literature.…”