title: 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.
authors.affiliation: 1 Programa de Residência de Clínica Médica do Hospital Santo Antonio, Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.|2 Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.|3 Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.
authors.forename: C A
authors.initials: CA
authors.lastname: Moura
authors.affiliation: 2 Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Santiago
authors.affiliation: 3 Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Neto
authors.affiliation: 4 Clínica de Assistência Multidisciplinar em Oncologia (AMO), Salvador, Bahia, Brazil.
authors.forename: V H
authors.initials: VH
authors.lastname: Gomes de Souza
authors.affiliation: 1 Programa de Residência de Clínica Médica do Hospital Santo Antonio, Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.|2 Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
authors.forename: C Geraldo
authors.initials: CG
authors.lastname: Moura
mesh_terms: D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001374:Azacitidine / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001856:Bone Marrow Examination; D003937:Diagnosis, Differential; D005260:Female; D006461:Hemolysis; D006801:Humans; D015477:Leukemia, Myelomonocytic, Chronic / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D011237:Predictive Value of Tests; D013921:Thrombocytopenia / Q000097:blood* / Q000175:diagnosis / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D000964:Antimetabolites, Antineoplastic; D015415:Biomarkers; C035356:SS-A antibodies; D001374:Azacitidine
keywords: Anti-DNA antibodies; hematologic changes; systemic lupus erythematosus