Bilateral toxoplasma retinochoroiditis in a patient with chronic myeloid leukemia treated with imatinib mesylate.
A 48-year-old man, on imatinib therapy for chronic myeloid leukemia, developed bilateral retino-choroiditis. Visual acuity was 20/100 and counting fingers at 2 m in both the right and left eye. Vitreous biopsy (left eye) revealed Toxoplasma gondii genome by polymerase chain reaction. Serum anti-toxoplasma IgG levels were significantly elevated. Blood counts were normal. Bcr-Abl/Abl transcript ratio was 0.016%. He was treated with oral co-trimoxazole, to which corticosteroids in tapering doses were added later. Imatinib therapy was continued. After 6 weeks of therapy, all retinal lesions regressed and vision improved to 20/30 and 20/40 in right and left eyes, respectively.
LV Prasad Eye Institute, Bhubaneswar 751 024, India.
Soumyava
S
Basu
Taraprasad
T
Das
Ghanshyam
G
Biswas
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001549:Benzamides; D002825:Chorioretinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D004247:DNA / Q000302:isolation & purification; D016678:Genome; D006801:Humans; D000068877:Imatinib Mesylate; D007108:Immune Tolerance; D007074:Immunoglobulin G / Q000097:blood; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D014122:Toxoplasma / Q000235:genetics / Q000302:isolation & purification; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014792:Visual Acuity
D000970:Antineoplastic Agents; D001549:Benzamides; D007074:Immunoglobulin G; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000068877:Imatinib Mesylate; D004247:DNA