title: Vertigo as the first sign of chronic myeloid leukemia: a case report and literature review.
abstract: Acute vestibular deficit as the first sign of leukemia is extremely rare. The literature shows some cases of sudden hearing loss accompanied by instability and associated with hyperviscosity syndrome. We present the case of a patient who presents a harmonic vestibular deficit of the right ear. The complementary studies revealed an abnormally high level of leukocytes. A peripheral blood cytogenetic analysis is performed due to a high suspicion of leukemia, and the results show BCR/ABL fusion gene with a cut point in the M-BCR region, which confirms the diagnosis of chronic myeloid leukemia. In this case we detail the importance of taking hematological disorders into consideration in the differential diagnosis of patients with otoneurological symptoms, and we also review the etiopathogenic mechanisms, symptoms, diagnosis, and therapeutic options for chronic myeloid leukemia with sudden hearing loss and vertigo.
authors.affiliation: Otoneurology Unit, Department of Otorhinolaryngology and Head and Neck Pathology, University Hospital of Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Martín-Hernández
authors.forename: Diego Hernando
authors.initials: DH
authors.lastname: Macías-Rodríguez
authors.forename: Víctor
authors.initials: V
authors.lastname: Martín-Sánchez
authors.forename: Cristina
authors.initials: C
authors.lastname: Cordero-Civantos
authors.forename: Santiago
authors.initials: S
authors.lastname: Santa Cruz-Ruiz
authors.forename: Angel
authors.initials: A
authors.lastname: Batuecas-Caletrio