All in the Family

Update Item Information
Identifier walsh_2022_s2_c2
Title All in the Family
Creator Homer Chiang; Shannon Beres
Affiliation (HC) (SB) Byers Eye Institute at Stanford, Palo Alto, California
Subject 6th nerve palsy, hemophagocytic lymphohistiocytosis, chemotherapy
History A previously healthy 2-year-old male presented to neuro-ophthalmology clinic for a head turn that started 1.5 months ago; and his left eye began turning in over the last 2 weeks. He had no recent infections, vaccinations, or illnesses. With the birth; of his new baby sister 6 weeks prior the family said they attributed the head turn to a new behavior from stress of a new; sibling. He had no headache or weakness noticed in the face or extremities and no drooling or dysphagia. He had a large; head that was consistently tracking on his own growth curve and followed closely by his pediatrician, who was his paternal; grandfather. Family history was notable for a maternal grandfather with multiple sclerosis and mother with history of optic; neuritis 10 years ago without recurrence. His maternal great grandmother had strabismus and his paternal great uncle had; strabismus requiring surgery. There is otherwise no family history of developmental delay, seizures or other neurologic; disorders. The exam showed a left abduction deficit with an esotropia of 55 prism diopters in primary gaze, 25 prism; diopters in right gaze, and increasing to >55 in left gaze. The anterior segments of both eyes were normal. There was very; subtle blurring of the optic disc margin in the left eye on quick view due to cooperation and the left optic nerve could not; be viewed due to the large esotropia. An urgent brain MRI with and without contrast was ordered and he was instructed to; begin patching the right eye due to amblyopia risk.
Disease/Diagnosis Familial hemophagocytic lymphohistiocytosis Type 2
Date 2022-02
References None
Language eng
Format application/pdf
Type Text
Source 54th Annual Frank Walsh Society Meeting
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2022
Collection Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2022. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6s0pnfx
Setname ehsl_novel_fbw
ID 2100235
Reference URL https://collections.lib.utah.edu/ark:/87278/s6s0pnfx
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