Journal of the Korean Ophthalmological Society 2006;47(6):1009-1015.
Published online June 30, 2006.
Cytomegalovirus Retinitis in a Child with Acute Lymphoblastic Leukemia.
Youn Hui Kim, Sang Kook Kim
Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea. simple521@chungbuk.ac.kr
급성 림프구성 백혈병 환아에서 발생한 거대세포바이러스망막염 1예
김연희,김상국
Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence:  Youn Hui Kim, M.D.
Abstract
PURPOSE
To report a case of cytomegalovirus (CMV) retinitis in a child who had been managed by immunosuppressive chemotherapy for acute lymphoblastic leukemia (ALL). METHODS: An 8-year-old boy who had been managed by immunosuppressive chemotherapy for ALL was referred to the ophthalmologic clinic because of blurred vision in his right eye. Fundus examination showed hard exudates and white retinal leaion in the macular area of the right eye, white retinal lesion accompanied with retinal hemorrhage and exudates in the midperipheral retina of the left eye. Serologic tests demonstrated a positive response of CMV antibody IgG and a negative response of CMV antibody IgM. CMV was isolated upon the culture of bone marrow and peripheral blood. Immunosuppressive chemotherapy was discontinued and ganciclovir was administered. RESULTS: Administration of ganciclovir led to clinical stabilization of the retinitis lesion that was accompanied by scarring. We were able to discontinue the administration of ganciclovir after the retinal lesions were resolved, and no recurrence of CMV retinitis was noted. CONCLUSIONS: Ganciclovir treatment was clinically effective in improving CMV retinitis in an immunocompromised child with ALL. In addition, the improved systemic immune function achieved by discontinuing immunosuppressive chemotherapy permitted discontinuation of anticytomegalovirus therapy.
Key Words: Acute lymphoblastic leukemia;CMV retinitis;Ganciclovir


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