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Colonic infiltration with chronic myelomonocytic leukemia
Andelka D LoSavio1, Alana P Bunnag, David T Rubin
1Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, IL 60637, USA.
Nature Clinical Practice. Gastroenterology & Hepatology
|April 4, 2007
Summary
This case study details a patient with chronic myelomonocytic leukemia who developed leukemic colitis. Treatment involved managing the leukemia and topical therapy, but the patient ultimately succumbed to complications.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- A 75-year-old female with a 6-year history of chronic myelomonocytic leukemia (CMML) presented with a month of non-bloody diarrhea, abdominal cramping, and urgency.
- Her condition progressed over months, leading to significant weight loss.
Observation:
- The patient's symptoms were investigated through physical examination, laboratory tests, stool studies, and colonoscopy with biopsies.
- Pathologic review and immunohistochemistry of biopsy specimens were performed.
Findings:
- The patient was diagnosed with leukemic colitis, a rare complication of hematologic malignancies.
- Management included systemic hydroxyurea for the underlying leukemia and topical 5-aminosalicylic acid for colitis.
Implications:
- This case highlights the importance of considering leukemic infiltration of the colon in patients with hematologic malignancies presenting with gastrointestinal symptoms.
- Early diagnosis and appropriate management of leukemic colitis are crucial, although outcomes can be poor, as demonstrated by the patient's progression to acute disseminated encephalomyelitis and death.
