Development of granulomatosis with polyangiitis in the patient with chronic myeloid leukemia: a case report and a short review of literature
Abstract
The association of granulomatosis with polyangiitis (GPA), a form of antineutrophil cytoplasmic antibodies-associated vasculitis (AAV), with neoplastic disease was reported. Most of the described cases are malignancies that develop in patients after long-term vasculitis medication.
The purpose of this paper is to review a rare case of the development of GPA in a patient suffering for more than a decade from chronic myeloid leukemia (CML). Such an association was a challenge for differential diagnosis because it had been initially considered a transition to the accelerated phase of CML or the development of secondary malignancy. Finally, a diagnosis of GPA was established, and medication with cyclophosphamide and subsequently with rituximab was administered. Such management, together with the continuation of medication against CML, led to significant improvement.
The possible associations between vasculitis and malignancy and their clinical implications were discussed.
From the point of view of clinical practice, it is important to remember that a diagnosis of a malignant disorder does not exclude the occurrence or new development of an autoimmune disease. Moreover, the symptoms and signs of both maladies may be akin, and an in-depth differential diagnosis is needed.
Keywords: granulomatosis with polyangiitisantineutrophil cytoplasmic antibodies-associated vasculitischronic myeloid leukemia
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