Korean J Pediatr Hematol Oncol.  2002 Oct;9(2):245-249.

A Case of Acute Sensorineural Hearing Loss as an Initial Manifestation in a Child with Acute Lymphoblastic Leukemia

• Song YG
• Park YS
• Chun EJ
• Kim SM
• Chung SY
• Kang JH
• Kim HK
• Jeong DC

Abstract

Acute sensorineural hearing loss is unusual as initial manifestations in a child with acute lymphoblastic leukemia (ALL), even though facial or oculomotor nerve palsy as early finding of leukemia was reported. The pathology of sensorineural hearing loss in leukemia showed as leukemic cell infiltration, hemorrhage, infection, and local ischemia due to hyperviscosity. A 12-year-old boy with ALL was admitted due to multiple cervical lymphadenopathy with left sided sensorineural deafness. He complained gross hematuria and purpura on whole body. His initial complete blood cell counts were hemoglobin 11.9 g/dL, hematocrit 34.3%, white blood cells 164,000/muL (segmented neutrophils 3%, lymphocytes 11%, monocytes 2%, immature blast 84%), and platelet 28,000/muL. Pure tone audiogram revealed profound sensorineural hearing loss of the left ear at all frequencies. His brain MRI showed no definite abnormal findings without hemorrhage or infarction in inner ear or temporal lobe. He received induction chemotherapy and total 4 times of transtympanic steroid injection with 1 week interval. His hearing power at complete remission was more improved than admission, but not completely recovered until 5 months. We proposed that hearing impairment might be an initial manifestation in acute leukemia with hyperleukocytosis.

Keyword

Sensorineural hearing loss; Hyperleukocytosis; Childhood acute lymphoblastic leukemia

MeSH Terms

Blood Cell Count
Blood Platelets
Brain
Child*
Deafness
Ear
Ear, Inner
Hearing
Hearing Loss
Hearing Loss, Sensorineural*
Hematocrit
Hematuria
Hemorrhage
Humans
Induction Chemotherapy
Infarction
Ischemia
Leukemia
Leukocytes
Lymphatic Diseases
Lymphocytes
Magnetic Resonance Imaging
Male
Monocytes
Neutrophils
Oculomotor Nerve Diseases
Pathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Purpura
Temporal Lobe