A Case of Erythema Nodosum and Serositis Associated with Myelodysplastic Syndrome

Abstract

Myelodysplastic syndrome (MDS) is a heterogenous group of stem cell disorders usually characterized by progressive refractory cytopenias, which could progress to acute myeloid leukemia. MDS may be associated with a wide spectrum of skin lesions, including neoplastic cell infiltration, Sweet's syndrome, pyoderma gangrenosum, erythema elevatum diutinum, vasculitis, and panniculitis. However, erythema nodosum is rarely associated with MDS. Unusual rheumatologic manifestations in patients with MDS also have been reported, which range from asymptomatic serological abnormalities to classic connective tissue disorders such as Sjogren's syndrome, relapsing polychondritis, systemic lupus erythematosus, rheumatoid arthritis and mixed connective tissue disease. However, concurrent erythema nodosum and serositis has rarely been reported. We describe a case of MDS with erythema nodosum and immune-mediated pericardial effusion in a 34-year-old woman.

Panniculitis as the Presenting Sign of a Myelodysplastic Syndrome in an Adolescent Boy

“…Panniculitis has been reported in children as the presenting feature of a subcutaneous T‐cell lymphoma and, in that situation, may also be associated with myelofibrosis or dermatomyositis (6). Similar to our patient, some unusual cutaneous manifestations in combination with atypical EN and MDS have been reported (7–10). In our young patient criteria for a Sweet syndrome were (both clinically and histopathologically) missing.…”

Antiplatelet Therapy in a Patient with Coronary Artery Disease and Myelodysplastic Syndrome with Thrombocytopenia

“…Both factors could decrease the suspicion of the hematologic process, and drug-eluting stents were implanted for the multivessel revascularization of the patient with complex coronary anatomy. With respect to the pericardial effusion, a serositis as autoimmune manifestation of myelodysplastic syndrome has rarely been reported (13,14). In these cases, the pericardial effusion usually responds to treatment with corticosteroids and this origin was unlikely in our patient.…”

The burden of autoimmunity in myelodysplastic syndromes

“…When considering immune‐mediated lung disorders, acute fibrinous and organizing pneumonia and pulmonary leukocytoclastic vasculitis were recorded, while in the ophthalmologic field, both autoimmune retinochoroidopathy and uveitis were described. Also an immune‐mediated pericardial effusion was observed in a single patient . Interestingly, also the possible association between autoimmune thyroid disease and MDS was suggested .…”

“…Also an immune-mediated pericardial effusion was observed in a single patient. 90 Interestingly, also the possible association between autoimmune thyroid disease and MDS was suggested. 91 Finally the condition of hyperhomocysteinemia was hypothesized to be somehow correlated with the occurrence of autoimmune manifestations in MDS patients.…”