Challenges in diagnosing concurrent acute leukemia in an immunosuppressed patient with systemic lupus erythematosus: A case report

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by damage to organs and cells, initially mediated by tissue-binding autoantibodies and immune complexes. Lymphomas have been frequently reported, but the association of SLE with acute leukemia is rare and likely coincidental. We report a case of a 40-year-old female admitted for an etiological diagnosis of fever and dyspnea with peripheral edema. She had a history of SLE diagnosed 2 years prior and had been on immunosuppressive therapy since then. Hematological investigations showed leukocytosis, anemia, and thrombocytopenia. Further diagnostic testing could not be done as she passed away 3 days after acute leukemia was diagnosed. This case highlights the challenges of diagnosing hematological malignancies in immunosuppressed SLE patients where symptoms may be obscured.