Abstract
A patient is present who has chronic lymphocytic leukemia (CLL) and developed a vasculitis involving the skin and large vessels along with immune complex mediated glomerulosclerosis. Both vasculitis and immune complex nephritis are rare manifestations of CLL.
Highlights
Chronic Lymphocytic leukemia is associated with a variety of autoimmune phenomenon, especially autoimmune cytopenias [1]
We report here a rare case of systemic vasculitis associated with chronic lymphocytic leukemia (CLL)
Based on the IF and EM results, this is likely a secondary form of focal segmental glomerulosclerosis associated with immune complex deposition (Figure 1A)
Summary
Chronic Lymphocytic leukemia is associated with a variety of autoimmune phenomenon, especially autoimmune cytopenias [1]. The patient is a 60 year-old Caucasian male with multiple comorbidities including coronary artery disease, paroxysmal atrial fibrillation and stage four B cell - CLL, diagnosed in May 2013 He had undergone 3 cycles of chemotherapy with Rituximab and Bendamustine. He presented with a maculo-papular rash 4 weeks after his last chemotherapy cycle that initially started in his lower extremities and spread to his entire body His CBC with 3.2% lymphocytes did not suggest a flare of disease. ASO Antibody titer was negative as were serologies for HSV, CMV and parvovirus Treatment with systemic corticosteroids led to resolution of his skin lesions and improvement of his renal function back to baseline He subsequently received a fourth cycle of chemotherapy.
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