Polymyalgia rheumatica and chronic lymphatic leukaemia

Area of Science:

• Rheumatology
• Hematology
• Oncology

Background:

• Polymyalgia rheumatica (PMR) is an inflammatory condition typically presenting with muscle pain and stiffness.
• The initial presentation of PMR usually involves normal lymphocyte counts.

Observation:

• A patient diagnosed with PMR exhibited normal lymphocyte counts at diagnosis.
• Biopsies revealed lymphocytic infiltration in the kidney and muscle, with a liver aspirate suggesting a possible leukemic process.
• Over five years, lymphocyte counts progressively increased in the peripheral blood and bone marrow.

Findings:

• The patient eventually developed chronic lymphatic leukemia (CLL), confirmed by typical hematological and clinical findings.
• This case demonstrates a temporal association between PMR and the development of CLL.

Implications:

• Persistent lymphocytosis in patients with polymyalgia rheumatica should raise suspicion for an underlying chronic lymphatic leukemia.
• Early recognition of this combination is crucial for appropriate patient management and treatment.
• This case contributes to understanding the potential overlap between inflammatory and hematologic malignancies.