Egyptian Society for Joint Diseases and Arthritis

KEYWORDSRheumatoid arthritis;Chronic myeloid leukemia;Pyoderma gangrenosumAbstract Rheumatoid arthritis may be associated with an increased risk of hematological malig-nancy. Increased lympho-proliferative malignancy in rheumatoid arthritis is often described; how-ever an increased risk of leukemia is not a common finding. A few cases of rheumatoid arthritishave been documented associated with chronic myeloid leukemia in the literature. We report anew case.Case presentation: A 36-year-old Moroccan female diagnosed as rheumatoid arthritis eight yearsago, was on remission under Methotrexate and prednisone. This therapy was stopped one yearbefore her admission at our hospital because of thrombopenia and anemia. She had polyarthritisflare. The physical examination found splenomegaly, hepatomegaly, and skin lesions at the trunkand limbs. Peripheral blood findings, peripheral smear and bone marrow aspiration diagnosed mye-loid leukemia in a blastic accelerated phase with negative Philadelphia chromosome. The skinlesions were diagnosed as pyoderma gangrenosum (skin biopsy). She received oral prednisoneand chemotherapy (Cytarabine and 6-Mercaptopurine). She had a complete response on the skinlesions, partial regression of splenomegaly, and improvement of her hematologic disorders. Unfor-tunately the patient died from septic shock after two weeks of post-chemotherapy pancytopenia.* Corresponding author. Tel.: +212 661374455; fax: +212 535613713 (S. Mansouri), tel.:+ 212 6 41 99 14 15 (W. Bono).E-mail addresses: samuela.med@hotmail.com (S. Mansouri), latifatahiri@yahoo.fr (L. Tahiri), sirin_elm@hotmail.com (I. Elmezouar),ncherqui@gmail.com (N. Cherqui), khamzineb@gmail.com (Z. Khammar), rhizberr@yahoo.fr (R. Berradi), rabhisamira@gmail.com (S. Rabhi),t_harzy@yahoo.fr (T. Harzy), wafaa.bono@gmail.com (W. Bono).Peer review under responsibility of Egyptian Society for Joint Diseases and Arthritis.