One month priapism in a 39 year old man with chronic myeloid leukaemia

Abstract

Background: Priapism is an involuntary prolonged erection unrelated to sexual stimulation and unrelieved by ejaculation. There are two types of priapism ; low flow (ischaemic ) and high flow priapism. It presents with engorgement of corpora carvernosa sparing the copora spongiosum and glans penis, and can be continous(sustained) or “stuttering”. “Stuttering” priapism is a term used for episodes that last less than 3 hours but are repeatitive1. Priapism was recognized as a serious complication of sickle cell disease as early as 19342 . 20% cases of priapism are related to haematological disoder3 .It is seen in 1-5% of males with all types of leukaemia4. There is a high index of suspicion of chronic myeloid leukemia in a non sickle cell adult patient presenting with priapism.
Method: Case note of the patient was retrieved for relevant information. The following information was obtained: date of the first contact , clinical findings, laboratory investigations for diagnosis eg peripheral and bone marrow aspiration blood film and BCR- ABL quantification; the ancilliary investigations ; liver function test, serum electrolyte, urea and creatinine etc. Abdominal and scrotal U/S information was also obtained.
Result: Patient had Philadelphia positive chronic myeloid leukaemia in chronic phase with complete loss of erectile function (erectile dysfunction)
Conclusion: Priapism is a rare presentation of chronic myeloid leukaemia, there should be a high index of suspicion of CML in a non sickle cell adult patient presenting with priapism

Key words: Priapism, Chronic myeloid leukaemia and erectile dysfunction