A case of adult T-cell leukemia presenting with scleritis
Purpose
To report a case of adult T-cell leukemia (ATL), which was diagnosed by examination of scleritis.
Methods
A 59-year-old female had been treated for scleritis, cataract, and dry eye with eye drops at a local clinic. She was referred to our hospital for further examination and treatment of thinning of sclera and bilateral visual loss due to cataract. At our initial examination, she also presented with erythematous papules and scales in her trunk and limbs. Skin biopsy revealed the accumulation of atypical lymphocytes to both epidermis and dermis. Anti Human T-cell lymphotrophic virus type 1 (HTLV-1) antibody was positive in the peripheral blood test and Adult T-cell leukemia cells were found in peripheral blood smears. In addition, monoclonal T-cell receptor gene rearrangement was detected. Computed tomography (CT) and FDG positron emission tomography (FDG-PET) showed the swelling and abnormal uptake of bilateral cervical lymph nodes. These clinical and laboratory findings led to a diagnosis of ATL. It was considered that scleritis was associated with the ATL.
Results
Scleritis was treated with topical betamethasone and visual loss was improved by cataract surgery. Regarding ATL, combination chemotherapy followed by allogenic bone marrow transplantation achieved complete remission.
Conclusion
It is important for clinicians to note that scleritis can be an ocular manifestation of ATL.
Conflict of interest
No
Author 1
Last name
HASEGAWA
Initials of first name(s)
E
City
Fukuoka
Country
Japan
Author 2
Last name
Yamana
Initials of first name(s)
S
City
Fukuoka
Country
Japan
Author 3
Last name
Yawata
Initials of first name(s)
N
City
Fukuoka
Country
Japan
Author 4
Last name
Takeda
Initials of first name(s)
A
City
Fukuoka
Country
Japan
Author 5
Last name
Sonoda
Initials of first name(s)
KH
City
Fukuoka
Country
Japan
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