Association of Acute Myeloid Leukemia and Systemic Lupus Erythematosus: A Case Report

Abstract

Systemic lupus erythematosus is an autoimmune Inflammatory disease that can affect multiple systems and organs of the body including skin, kidneys, lungs, joints and nervous system.Some previous studies up light thatSLE was associated with increased risk of Acute leukemia (SIR = 2.3). The incidence ofthe association of AMLand SLE is not known but there are few case reports in literature. The aim of this report was to up light the difficulties wich occurred in the diagnosis and the management of acute myeloid leukemia in patient with systemic lupus erythematosus. Patient, 43 years old, diabetic treat withinsulin, wichsister is followed for Behcet's disease, was admited for AML with trisomy of chromosome 4 and 8 and thrombophlebitis of the superior sagittal sinus, Chest CT-Scan showed minimal bilateral pleural effusion. She was treated according to Morocco National protocol AML-MA-2011. CT-Scan was done atday 12 ofchemotherapy and noticedthe persistance of the minimal bilateral pleural effusion.At day 19 the patient presentedmalar rash, and right axillary adenitis. The biopsy of the adenitis show the presence of LE cells. According to internal physician recommendations we add steroids to the treatement. The cough and fever deasapear. The CT-scan for control was normal after two weeks of steroids. Patient is in complete remission after induction I. After a following-up of five months, the patient still well,but present severy infections during chemotherapy cycles and a bad tolerance for the treatement. The association SLE-AML is rare. The diagnosis of the association SLE-AML is difficult. It is management is also difficult according to commorbidity, severy infectious because of dicline of immunity, and less tolerance to AML chemotherapy.