Chronic myelomonocytic leukemia mimicking hematologic systemic lupus erythematosus

Abstract

The relationship between primary hematologic disease and rheumatologic manifestations is well known, especially acute lymphocytic leukemia, lymphomas, plasma cell dyscrasias and myelodysplastic syndrome (MDS). Currently, more has been described about autoimmune manifestations in chronic myelomonocytic leukemia (CMML). Many different clinical scenarios may lead a patient with MDS/CMML initially to seek a rheumatological unit. Autoimmune features such as polymyalgia rheumatic symptoms, myositis, neutrophilic dermatosis, cutaneous vasculitis and positive antinuclear antibodies (ANA) are some examples of clinical presentation of MDS/CMML. Moreover, peripheral cytopenias are a common initial presentation both for systemic lupus erythematous (SLE) and MDS/CMML. The aim of this study was to describe a case of an elderly woman with thrombocytopenia and positivity of antibodies to anti-extractable nuclear antigens (anti-ENA) as initial manifestation of CMML mimicking SLE, and to present some clues that encourage the clinician to perform a bone marrow study in such a clinical scenario.

Myelodysplastic Syndrome Combined with Systemic Lupus Erythematosus: A Case Report

“…According to a report, Some patients diagnosed with MDS have abnormalities in SLE and rheumatoid arthritis related anti autoantibodies before diagnosis (Kelmenson, Wagner, McNair, et al, 2020). Moura et al reported a case of SLE combined with chronic myelomonocytic leukemia (formerly classified as a subtype of MDS, now an independent disease) and suggested conducting comprehensive bone marrow examinations when patients have abnormal blood counts (Moura, Santiago, Neto, Gomes de Souza, & Moura, 2017). These patients exhibited both immune dysfunction and hematopoietic dysfunction, possibly due to immune dysregulation leading to different rheumatic disease manifestations.…”

A busca por uma política nacional dos biocombustíveis como tutela do direito fundamental ao meio ambiente: acautelamento e avaliação de riscos

“…O processo de destilação do etanol produz um resíduo chamado vinhoto, sendo que para cada litro de etanol produzido são gerados de 10 a 13 litros de vinhoto. Determinada quantidade do vinhoto produzida pode ser utilizada como fertilizante se diluído em água, todavia, para evitar o risco de salinização do solo é necessário analisar detalhadamente sua composição química e morfológica e o tipo específico da vinhaça para a correta aplicação, além de ser uma substância que contamina rios e fontes de água subterrâneas 195 .…”