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Titre	A child with bilateral proptosis: a sign of acute myeloid leukaemia?
Abstract Nr.	136

But	A 5-year-old girl from Ruanda was referred to our department with severe bilateral proptosis, a bloody and necrotic chemosis of the conjunctiva and infraorbital tissues and a left facial paresis. There was a 3-month history of pancytopenia.
Méthodes	She was investigated with complete blood count, peripheral blood smear and bone marrow puncture. Furthermore, an ophthalmic examination with B-scan ultrasonography and Computed Tomography of the brain was carried out.
Résultats	Ophthalmic examination showed a bilateral proptosis with a severe protrusion of the palpebral conjunctiva and infraorbital tissues. Visual acuity was counting fingers at 30 cm in the right eye and at 1 meter in the left eye. Biomicroscopy revealed semimydriatic, non-reactive pupils, a clear cornea and a normal anterior segment. Perkins tonometry showed hypotonia in both eyes. Fundoscopy showed bilateral retinal haemorrhages, but no signs of papilloedema. B-scan ultrasonography demonstrated a choroidal invasion combined with serous detachment in both eyes and subcutaneous invasion. CT scan demonstrated bilateral intraorbital malignant infiltrates with an extraconal localization against the orbital roof and lateral wall and also in the maxillary sinus. Oncologic investigation with morphology, cytochemistry and immunophenotyping of the bone marrow were conclusive of the diagnosis of acute myeloid leukaemia, type AML-M1.
Conclusion	Bilateral childhood proptosis can be a sign of malignant orbital infiltration with AML. Referral to a paediatric oncologist with examination of the peripheral blood count, and if necessary a bone marrow aspirate, is mandatory.

Auteur 1

Nom	SWINNEN
Initiales	S
Institut	Department of Ophthalmology
Ville	Leuven

Auteur 2

Nom	Uyttebroeck
Initiales	A
Institut	Department Paediatric Haemato-Oncology
Ville	Leuven

Auteur 3

Nom	Boeckx
Initiales	N
Institut	Department of Laboratory Medicine
Ville	Leuven

Auteur 4

Nom	Casteels
Initiales	I
Institut	Department of Ophthalmology
Ville	Leuven