Hairy Cell Leukemia Masquerading as Pancytopenia in Pregnancy

Area of Science:

• Hematology
• Oncology
• Dermatology

Background:

• Thrombocytopenia is a common pregnancy complication.
• Hairy Cell Leukemia (HCL) is a rare B-cell malignancy often presenting with low platelets.
• Pregnancy can mask or complicate the diagnosis of hematological disorders.

Observation:

• A pregnant patient presented with pancytopenia and persistent thrombocytopenia postpartum.
• The thrombocytopenia was associated with a vesicular, pustular rash diagnosed as Sweet's syndrome.
• Standard treatments for similar conditions were ineffective.

Findings:

• Comprehensive investigations confirmed Hairy Cell Leukemia (HCL).
• Treatment with cladribine led to hematological remission of HCL.
• Cladribine also resolved the Sweet's syndrome and normalized platelet count.

Implications:

• Highlights the importance of a broad differential diagnosis for thrombocytopenia in pregnancy.
• Underscores the need for thorough investigation of non-responsive cases.
• Suggests cladribine as an effective treatment for HCL presenting with dermatological manifestations during pregnancy.