[Polymyalgia rheumatic and chronic myelomonocytic leukemia]

Area of Science:

• Hematology
• Rheumatology
• Internal Medicine

Background:

• Myelodysplastic syndromes (MDS) can present with systemic symptoms, including rheumatological conditions like connective tissue diseases and vasculitis.
• Rheumatological manifestations are recognized complications within the context of myelodysplastic syndromes.
• This report details a patient with chronic myelomonocytic leukemia (CMML) experiencing systemic symptoms of polymyalgia rheumatica and pericarditis.

Observation:

• A 78-year-old patient with a three-year history of CMML presented with inflammatory shoulder pain and systemic symptoms.
• The patient exhibited biological inflammatory syndrome, asthenia, anorexia, and significant weight loss.
• Diagnostic workup confirmed polymyalgia rheumatica and a pericardial effusion requiring urgent drainage.

Findings:

• The patient's symptoms of polymyalgia rheumatica and pericarditis emerged during a period of worsening hematological status in his CMML.
• Rheumatological symptoms resolved favorably with short-term corticosteroid treatment.
• The pericarditis did not recur during a two-year follow-up period.

Implications:

• Screening for myelodysplastic syndromes (MDS) is recommended for patients presenting with systemic manifestations, particularly in elderly individuals with cytopenia, macrocytosis, or monocytosis.
• This case underscores the importance of considering hematological disorders in the differential diagnosis of unexplained rheumatological and systemic inflammatory conditions.
• Timely diagnosis and management of MDS-associated systemic symptoms can lead to favorable patient outcomes.