Pearls from 11/09/21 LEADS

Tuesday, November 9, 2021

The November 09, 2021, session of Duke Medicine LEADS featured Sebastian Franco, MD, Brittany Chapman, MD, Nathan Hirshman, MD, Dilraj Grewal, MD, Carlos De Castro, MD, presenting "Painful Ophthalmoplegia: An Atypical Presentation of a Systemic Illness." 

  • The routine outpatient differential for anemia should include early presentation of myelodysplastic syndrome(s). The differential diagnosis for pancytopenia is broad and should include primary bone marrow processes as well as peripheral destructive processes.
  • Painful ophthalmoplegia should raise the spectre of orbital mass and can be approached by invoking a classical medicine inflammatory triad including rheumatologic, oncologic and infectious etiologies.
  • Typical presentation of AML is due to bone marrow failure including symptomatic anemia, neutropenia leading to fevers and infection and thrombocytopenia leading to bruising and petechiae. There are a number of uncommon presentations of AML that include bone pain, joint pain, arthritis (4%) CNS involvement (<5%) and myeloid sarcoma with peripheral tissue infiltration by leukemic cells (<1%). 

Watch the recorded session

Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.