Sha Ibad, Kurian Nishanth P, Majeed Ibrahim S
Department of Orthopedic Surgery, The Lifeline Multi Speciality Hospital, Adoor, IND.
Department of Orthopedics, The Lifeline Multi Speciality Hospital, Adoor, IND.
Cureus. 2025 Apr 3;17(4):e81650. doi: 10.7759/cureus.81650. eCollection 2025 Apr.
Leukemic arthritis is a rare but clinically significant presentation of leukemia, often resembling inflammatory or autoimmune arthritis. Axial joint involvement, particularly sacroiliitis, is an uncommon manifestation and can mislead clinicians, delaying the diagnosis of the underlying hematologic malignancy. We present the case of a 34-year-old woman with persistent low back pain, initially diagnosed as sacroiliitis and treated with conventional therapies. Despite partial symptom relief with nonsteroidal anti-inflammatory drugs and corticosteroids, her condition worsened, leading to further evaluation. Subsequent laboratory tests revealed leukocytosis and anemia, and a peripheral blood smear confirmed leukemic infiltration. The final diagnosis of paraneoplastic sacroiliitis secondary to acute leukemia was established. This case highlights the importance of considering malignancy in patients presenting with refractory arthritis, particularly when symptoms are atypical or fail to respond to standard treatments. Early recognition and prompt initiation of chemotherapy can significantly improve clinical outcomes..
白血病性关节炎是白血病一种罕见但具有临床意义的表现，常类似炎性或自身免疫性关节炎。轴性关节受累，尤其是骶髂关节炎，是一种不常见的表现，可能会误导临床医生，延误潜在血液系统恶性肿瘤的诊断。我们报告一例34岁女性，她持续存在下背部疼痛，最初被诊断为骶髂关节炎并接受了传统治疗。尽管使用非甾体类抗炎药和皮质类固醇后症状部分缓解，但她的病情仍恶化，从而进行了进一步评估。随后的实验室检查显示白细胞增多和贫血，外周血涂片证实有白血病浸润。最终确诊为继发于急性白血病的副肿瘤性骶髂关节炎。该病例强调了在难治性关节炎患者中考虑恶性肿瘤的重要性，特别是当症状不典型或对标准治疗无反应时。早期识别并及时开始化疗可显著改善临床结局。
