The arthritis of leukemia

Abstract

Arthritis related to the primary disease was detected in 10 of 74 (13.5% patients seen primarily for leukemia [2 of 12 patients with acute (16.6% and 8 of 62 (12.4%) with chronic leukemia]. To these were added 18 ad ditional patients previously diagnosed of having arthritis of leukemia.Clinical analyses of 28 patients with arthritis of leukemia showed that the arthritis of acute leukemia was commonly asymmetric, additive, polyarticular and often part of the initial manifestation of the disease. The arthritis of chronic leukemia was similar t o the acute but was often symmetric and usually appeared as a late manifestation. X-ray films of affected joints were abnormal in 7 patients. Mild hyperuricemia was found in 15.8%, rheumatoid factor in none and antinuclear antibodies in 11% of patients with arthritis of leukemia. Leukemic infiltration of the synovial membrane was found in all 3 of the patients who underwent synovial biopsy and is believed to be the cause of the arthritis.Although arthritis is a known manifestation of acute leukemia (1-5), its occurrence in chronic leukemia is not well recognized ( 6 , 7 ) , and its prevalence has not been reported. This study describes the clinical characteristics and frequency of joint manifestations in a group of patients with chronic and acute leukemia. The incidence of rheumatoid factor, hyperuricemia, antinuclear antibodies and roentgenogram abnormalities was determined. Further, histologic examinations of synovial biopsies were performed in 3 patients.

Metastatic adenocarcinoma of synovium presenting as an acute arthritis. diagnosis by closed synovial biopsy

“…There have also been a few reports of arthritis secondary to direct tumor invasion in and about joints, and recently the occurrence of acute arthritis due to leukemic infiltration of the synovium has been reported (11,12). T o our knowledge, the following is the first report of metastatic carcinoma to the synovium presenting as an acute arthritis.…”

Diagnosis of malignancies in children with musculoskeletal complaints

“…2,3 Several studies concerning the musculoskeletal manifestations of childhood leukemias have shown the importance of these complaints in the clinical presentation and follow-up of these patients. 1,[4][5][6][7][8][9][10] The aims of the present study were to determine retrospectively the frequency and type of occult neoplasias in children who initially presented with musculoskeletal complaints, as well as determining the clinical features and laboratory alterations that can suggest such malignancy.…”

Arthritis of the knees in b cell chronic lymphocytic leukemia: a patient with immunologic evidence of b lymphocytic synovial infiltration

“…The specific synovial infiltration by lymphocytic cells represented a more probable mechanism. This has been rarely demonstrated since the availability of synovial fluid examination andlor synovial biopsy (2). The identification of the phenotype of the peripheral blood, skin, and synovial lymphocytes allowed us to state that the arthritis, as well as the skin lesions, constituted a specific localization of CLL in our patient.…”

“…The identification of the phenotype of the peripheral blood, skin, and synovial lymphocytes allowed us to state that the arthritis, as well as the skin lesions, constituted a specific localization of CLL in our patient. The identification of leukemic cells in synovial fluid (T cell leukemia) has been reported previously (1)(2)(3)(4) …”