Chronic Myelomonocytic Leukaemia (CMML) and Vasculitis: A Rare but Known Association
Published: 2023-11-22
Page: 271-276
Issue: 2023 - Volume 6 [Issue 4]
Yih Hoong Lee *
Department of Medicine, Sibu General Hospital, Ministry of Health, Sibu, Sarawak, Malaysia.
Shan Kai Ing
Department of Medicine, Sibu General Hospital, Ministry of Health, Sibu, Sarawak, Malaysia.
Jian Yuan Cheng
Department of Pathology, Sibu General Hospital, Ministry of Health, Sibu, Sarawak, Malaysia.
Kelly Kee Yung Wong
Department of Radiology, Sibu General Hospital, Ministry of Health, Sibu, Sarawak, Malaysia.
Grace Wan Chieng Lee
Department of Medicine, Division of Haematology, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Aims: To illustrate the relationship between Chronic Myelomonocytic Leukaemia (CMML) and Systemic inflammatory and autoimmune diseases (SIADs).
Presentation of Case: This report presents a case of a 68-year-old gentleman with newly-diagnosed CMML with SIADs. The diagnosis of CMML was confirmed with bone marrow examination findings and a negative BCR-ABL fusion gene. During hospitalization, the patient developed painless right inguinal swelling. Urgent imaging revealed focal arteritis of the right distal external iliac/proximal common femoral artery and a small focal dissection of the infrarenal abdominal aorta. However, he was asymptomatic and reported no other connective tissue disorder symptoms. He was started on cytoreductive therapy for CMML and was treated conservatively for the arteritis and dissection of the infrarenal abdominal aorta. A follow-up scan revealed resolution of arteritis.
Discussion: Chronic myelomonocytic leukaemia (CMML) with systemic inflammatory and autoimmune diseases (SIADs) is rare. The mainstay of treatment is corticosteroids, immunosuppressants, and, most importantly, treating the underlying cause.
Conclusion: This case highlighted the importance of recognizing the possible SIADs associated with CMML. Treating the CMML might lead to resolution of SIADs.
Keywords: Chronic myelomonocytic leukaemia, systemic inflammatory and autoimmune diseases, vasculitis, cytoreduction