J Korean Ophthalmol Soc.  2006 Jun;47(6):1009-1015.

Cytomegalovirus Retinitis in a Child with Acute Lymphoblastic Leukemia

• Kim YH
• Kim SK

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.

Keyword

Acute lymphoblastic leukemia; CMV retinitis; Ganciclovir

MeSH Terms

Bone Marrow
Child*
Cicatrix
Cytomegalovirus Retinitis*
Cytomegalovirus*
Drug Therapy
Exudates and Transudates
Ganciclovir
Humans
Immunoglobulin G
Immunoglobulin M
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Recurrence
Retina
Retinal Hemorrhage
Retinaldehyde
Retinitis
Serologic Tests
Ganciclovir
Immunoglobulin G
Immunoglobulin M
Retinaldehyde