Chronic myeloid leukaemia presenting with priapism as the only symptom: A case report and review of literature.
Keywords:
Priapism, Chronic myeloid leukaemia, erectile dysfunctionAbstract
Objective: There have been few reports of priapism as complications of various haematological malignancies. Delays in establishing the cause and late institution of appropriate intervention in patients suffering from priapism could result in long-term complications, especially erectile dysfunction. We present here a case of chronic myeloid leukaemia (CML) in a 30 year old male who presented with priapism as the only symptom. Apart from presenting this as a rare case report, it also emphasizes the need for early full blood count in patients presenting with priapism.
Methods: The case note of the patient, as well as all available literature on the subject were reviewed.
Results: The 30 year old man who presented with a 9 (nine) day history of persistent painful non-sexually related penile erection was found to have chronic myeloid leukaemia (CML) following peripheral and bone marrow aspiration studies. He however had a delay in referral and diagnosis of his primary condition and eventually had erectile dysfunction. The priapism responded well to surgical intervention and use of cyto-reductive therapy. The erectile dysfunction could have been averted if complete blood count and, or peripheral blood film were carried out at the time of first presentation
Conclusion: Priapism due to hyperviscosity can be the first presentation in patients with Chronic Myeloid Leukaemia, and CML should therefore always be considered in a patient with priapism. High Index of Suspicion, as well as early full blood count and peripheral blood/Bone marrow examination among patients presenting with priapism will facilitate prompt and correct diagnosis, and reduce, if not prevent erectile dysfunction and other severe complications that may arise from priapism.
References
Ryan R, Zak L and Mhairi C. How I manage p r i a p i s m i n c h r o n i c m y e l o i d
leukaemia patients. British Journal of Haematology, 2012, 158, 155–164
Winter C, Mcdowell G. Experience with 105 patients with priapism: Update review of all aspects. J Urol 1988;140:980-983.
Eland, I.A, van der Lei, J, Stricker B.H. & Sturkenboom. Incidence of priapism in the general population. Urology 2001, 57, 970–972.
Hoffman. Hematology: Basic principle and practice 4th ed. Churchill living stone an imprint of Elsevier 2005; 261-272.
Hamre MR, Harmon EP, Kirkpatrick DV.
Priapism as a complication of sickle cell disease. J Urol. 1991; 145(1):1-5.
Nwogoh B, Adewoyin A, Bazuaye GN,
Nwannadi IA. Prevalence of Priapism among Adult Male Sickle Cell Disease Populace seen at the University of Benin Teaching Hospital, Benin City. Nig Med Pract 2014; vol. 65 No. 1-2
Hauri D, Spycher M, Bruhlman W. Erection and priapism: a new physiological concept. Urol Int. 1983;38:138-145
Francis RB, Johnson CS. Vascular occlusion in sickle cell disease. Current concepts and unanswered questions. Blood 1991;77:14051414.
FitzpatrickTJ. Spongiograms and cavernosograms: a study of their value in priapism. J Urol 1973;109:843
Saenz de Tejada I, Ware JC, Blanco R, Pittard JT, Nadig PW, Azadzoi KM, et al. Patho-physiology of prolonged penile erection associated with trazodone use. J Urol 1991;145:60-64.
Stackl W, Mee SL. Priapism. In: Krane RJ, Siroky MB, Fitzpatrick JM. Clinical Urology. Philadelphia: J.B.Lippincott, 1994:1245-8.
Diggs LW, Ching RE. Pathology of sickle cell anaemia. South Med J 1934;27:839-845
Nwannadi IA, Alao OO, Akpa P. Priapism in sickle cell anaemia patients: a review of Aetiopathogenesis and current management approach. Ann biomed. Sci. 2013;12(1):49-66
Meng-W, Chung-C, Shy-Shin. Priapism-- A Rare Presentation in Chronic Myeloid
Leukemia: Case Report and Review of The
Literature. Chang Gung Med J 2003;26:288-292
John MG, Tariq IM. Chronic myeloid leukaemia. In: Hoffbrand AV, Catovsky D, Tuddenhan EG. Postgraduate haematology. 5th ed. Blackwell publishing 2005.
Savage D, Richard MS, and John MG. Clinical features at diagnosis in 430 patients with chronic myeloid leukaemia seen at a referral centre over a 16-year period. British Journal of Haematology, 1997, 96, 111–116
Stephens DJ. Relation of viscosity of blood to leukocyte count, with particular reference to chronic myelogenous leukemia. Proceedings of the Society for Experimental Biology and Medicine. 1936; 35, 251–256.
Lichtman MA. Rheology of leukocytes, leukocyte suspensions, and blood in leukemia: possible relationship to clinical manifestations. Journal of Clinical Investigation; 1973; 52, 350–358.
Hild DH & MyersTJ. Hyperviscosity in chronic granulocytic leukemia. Cancer. 1980; 46, 1418–1421.
Lichtman MA & Rowe JM. Hyperleukocytic leukemias: rheological, clinical, and therapeutic considerations. Blood. 1982; 60, 279–283.
Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, et al. American Urological Association guideline on the management of priapism. Journal of Urology. 2003; 170, 1318–1324.
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