Department of Family Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA.
Family Medicine, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA.
BMJ Case Rep. 2020 Dec 22;13(12):e238371. doi: 10.1136/bcr-2020-238371.
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.
我们报告了一例新诊断的同时患有细胞质抗中性粒细胞胞浆抗体阳性血管炎和慢性淋巴细胞白血病(CLL)的患者。该患者为 79 岁男性,表现为黑便、咯血、急性缺氧和急性肾损伤。在当前的文献中,c-ANCAs 血管炎和恶性肿瘤的关联很少见,但非常少见,如果有的话,c-ANCAs 血管炎和 CLL 之间的关联。由于存在两种病理,且血管炎的表现不常见,因此该病例较为独特。他表现出肾脏和肺部的症状,与血管炎常见的皮肤表现不同。我们认为,这可能是一种容易被忽视的疾病组合,因此,本病例的目的是防止因忽视而导致的治疗延误,从而影响患者的预后,并鼓励进一步研究这些疾病之间的关系。