Autoimmune myelofibrosis: a rare haematological involvement in systemic lupus erythematosus

BMJ Case Rep. 2019 Jan 14;12(1):bcr-2018-227520. doi: 10.1136/bcr-2018-227520.

Abstract

Autoimmune myelofibrosis is a distinct clinicopathological entity that occurs with autoimmune disorders. We report the case of a 44-year-old woman admitted with pancytopenia and clinical features of systemic lupus erythematosus, Sjogren's syndrome and antiphospholipid antibodies syndrome. Bone marrow biopsy showed decreased global cells and an increase of reticulin fibres on argentic coloration, consistent with myelofibrosis. The JAK2 V617, Myeloproliferative leukemia (MPL) and calreticulin mutations were negative. The patient's condition improved after treatment with hydroxychloroquine, vitamin K antagonists and prednisone.

Keywords: haematology (incl blood transfusion); immunology; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antiphospholipid Syndrome / diagnosis
  • Antirheumatic Agents / therapeutic use
  • Autoimmune Diseases / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Hydroxychloroquine / administration & dosage
  • Hydroxychloroquine / therapeutic use
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / pathology
  • Pancytopenia / diagnosis
  • Pancytopenia / etiology*
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Primary Myelofibrosis / drug therapy
  • Primary Myelofibrosis / immunology
  • Primary Myelofibrosis / pathology*
  • Sjogren's Syndrome / diagnosis
  • Treatment Outcome
  • Vitamin K / antagonists & inhibitors*
  • Vitamin K / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Vitamin K
  • Hydroxychloroquine
  • Prednisone