A diagnostic challenge: chronic myelomonocytic leukaemia and recurrent anterior ischaemic optic neuropathy
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We report the first case of ischaemic optic neuropathy (ION) linked to chronic myelomonocytic leukaemia (CMML) and its associated vasculitis. We discuss the link between CMML and vasculitis and the evidence suggesting it can cause anterior ischaemic optic neuropathy through a vasculitic process. We highlight the difficulty and delay in diagnosis as the use of steroids masked an underlying systemic process. Recurrent ION and raised inflammatory markers should raise suspicion of vasculitis. Together with an elevated monocyte but low platelet count, CMML should be considered.
KeywordsVasculitis ANCA Steroids Recurrent Visual Loss Anterior Ischaemic Optic Neuropathy CMML
Anterior Ischaemic Optic Neuropathy
Arteritic-Anterior Ischaemic Optic Neuropathy
Vasculitis Related-Anterior Ischaemic Optic Neuropathy
Chronic Myelomonocytic Leukaemia
Non-Arteritic Anterior Ischaemic Optic Neuropathy
The case was encountered and the work was completed at Croydon University Hospital. The authors have no proprietary or commercial interest in any of the materials displayed in this case report.
Conflict of interest
The authors have no conflict of interest
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