Relationship between vasculitis and chronic lymphocytic leukaemia: a correlation without causation

BMJ Case Rep. 2020 Dec 22;13(12):e238371. doi: 10.1136/bcr-2020-238371.

Abstract

We report a novel case of a patient who presented with new diagnoses of both cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCAs) positive vasculitis and chronic lymphocytic leukaemia (CLL). The patient was a 79-year-old man who presented with melena, haemoptysis, acute hypoxia and acute kidney injury. In the current literature, there are rare associations of c-ANCA vasculitis and malignancy, but very few, if any, relating c-ANCA vasculitis and CLL. This case is unique due to the presence of both pathologies and an uncommon presentation of the vasculitis. He presented with renal and pulmonary findings, unlike the dermal manifestations commonly seen with vasculitis. We think that this could be an easily overlooked combination of diseases and, therefore, the purpose of this case is to prevent delays in care that could affect patient outcomes and also to encourage further research into the relationship between these diseases.

Keywords: immunology; oncology; renal medicine; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / immunology
  • Acute Kidney Injury* / pathology
  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / blood
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / diagnosis
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / drug therapy
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / immunology
  • Antibodies, Antineutrophil Cytoplasmic* / blood
  • Biopsy
  • Bone Marrow / pathology
  • Drug Therapy, Combination / methods
  • Humans
  • Kidney / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell* / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell* / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell* / immunology
  • Male
  • Melena* / diagnosis
  • Melena* / immunology
  • Prednisone / therapeutic use
  • Rituximab / therapeutic use
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Prednisone
  • Rituximab