Sudden onset hearing and visual loss: An unusual presenting manifestation of chronic phase chronic myeloid leukaemia

Chronic Myeloid Leukaemia (CML) commonly presents with generalized weakness, splenomegaly, leucocytosis with basophilia, while neurological manifestations like convulsions, hearing loss, papilledema are rare. Moreover, hearing and or vision loss is seldom encountered as a primary manifestation [1-6], with various mechanisms implicated for vascular obstruction and end organ dysfunction [4]. We hereby, report a retrospective series of six patients with CML in Chronic Phase (CP) who presented with visual loss and/or Sensorineural Hearing Loss (SNHL). Due to the rarity of this presentation we feel our case series could contribute to the existing scarce literature. A detailed history and clinical examination including auditory and ophthalmological evaluation were performed in each patient. Related radiological evaluation was done as needed. Data was recorded by reviewing the electronic medical records and patient charts. All patients were given imatinib as first line Tyrosine Kinase Inhibitor (TKI). Pure Tone Audiometry (PTA) and fundoscopy were performed at diagnosis and repeated post one month of treatment with imatinib. Patients were followed-up as per standard international guidelines.