Rheumatic manifestations as initial presentation of malignancy: A case series from a tertiary care center in India

Abstract

Objective Malignant neoplasms can be associated with a wide variety of rheumatological manifestations that may be caused by direct tumor invasion into bones and joints, as a paraneoplastic syndrome, and through altered immune surveillance. To identify the relationship between rheumatic manifestations in various malignancies. Methods Twenty patients with various malignancies presenting with rheumatic conditions in our tertiary medical care were studied retrospectively from case records at the Kalinga Institute of Medical Sciences from 2013 to 2018. Results In the present study, total of 20 patients including 12 males and 8 females with mean age at diagnosis of was 46.3±22.2 years with various malignancy associated rheumatic diseases were included. In total 20% of patients with were current smokers. Seven (35%) had hematological malignancies whereas 13 (65%) had solid malignancies. Most common presenting feature was arthritis (40%), followed by weight loss (20%), skin rash (10%), fever (15%) and muscle weakness (10%) at the time of diagnosis. All of them developed malignancy within 24 months of diagnosis. Among the autoantibodies, only 6 patients (30%) were positive for both ANA (n= 4, 20%) and RF (n=2, 10%), other antibodies were negative. The patients in the hematological malignancies had significantly higher serum levels of LDH, Mean±SD U/L compared to solid malignancy group (716.8±169.6 vs. 249.9±161.6, p<0.001). Conclusion In our cohort, all the patients developed malignancies within 2 years of diagnosis of rheumatic condition. Higher serum LDH levels helpful to differentiates between hematological and solid malignancies. Hence early detection of malignancy is of major importance in these patients.

Study of serum interleukin 35 level in patients with acute myeloid leukemia

“…In this study, first hour ESR in AML patients showed statistically significant increase as compared to the control group. This agreed with Padhan P et al [19] who stated that ESR is elevated in solid and haematological malignancies. In our study, all AML cases were positive for CD 45 and CD 33, and this agreed with Haque S, et al [20] who stated that CD 45 was positive in all their cases while CD 33 was positive in 95% of their cases.…”

Kas iskelet sistemi yakınmalarında neoplastik hastalıkların değerlendirilmesi

“…Literatürde yapılan çalışmalarda en sık KİS bulguları ile başvuran malign hastalık ALL'dir (8)(9)(10)(11)(12)(13). Bizim çalışmamızda ise en sık saptanan malign hastalık NHL olup, ikinci sıklıkta saptanan malign hastalık ALL'dir.…”