title: Concurrent hypopituitarism and leukemic retinopathy in a child with B-precursor acute lymphoblastic leukemia and isolated central nervous system relapse.
abstract: Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of B-precursor all without cns involvement. Three months after chemotherapy completion, she presented with lower-extremity weakness and was diagnosed with an isolated cns relapse. Concurrent hypopituitarism and leukemic retinopathy were also found. After receiving craniospinal radiotherapy and systemic chemotherapy, her retinopathy and vision improved. She is now in complete remission, and she is still on chemotherapy according to the guideline from the Pediatric Oncology Group. Although rare, hypopituitarism and leukemic retinopathy should be taken into consideration in patients with cns involvement by leukemia.
authors.affiliation: School of Post Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung; Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung.
authors.forename: K H
authors.initials: KH
authors.lastname: Wu
authors.affiliation: Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan; College of Medicine, Chang Gung University, Taoyuan.
authors.forename: H P
authors.initials: HP
authors.lastname: Wu
authors.affiliation: Department of Ophthalmology, China Medical University Hospital, Taichung; Department of Medical Research, China Medical University Hospital, Taichung.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: Division of Genetics and Metabolism, Children's Hospital, China Medical University, Taichung.
authors.forename: C H
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Radiology, China Medical University Hospital, Taichung.
authors.forename: H Y
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung.
authors.forename: T
authors.initials: T
authors.lastname: Weng
authors.affiliation: Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung; Department of Biotechnology and Bioinformatics, Asia University, Taichung.
authors.forename: C T
authors.initials: CT
authors.lastname: Peng
authors.affiliation: Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Y H
authors.initials: YH
authors.lastname: Chao
keywords: Hypopituitarism; acute lymphoblastic leukemia; central nervous system relapse; retinopathy