J Rheum Dis.  2012 Aug;19(4):212-215. 10.4078/jrd.2012.19.4.212.

A Case of Giant Cell Arteritis Accompanied by Acute Myeloid Leukemia

• Hwang Y
• Lee SH
• Hong SC
• Kim DY
• Kim YJ
• Seo JW
• Son IS
• Jung HA
• Choi HS
• Lee JH
• Kim HR

• KMID: 2223073
• DOI: http://doi.org/10.4078/jrd.2012.19.4.212

Abstract

Giant cell arteritis (GCA), the most common form of systemic vasculitis in adults, preferentially involves large and medium-sized arteries in patients over the age of 50. The classic manifestations are headaches, jaw claudication, polymyalgia rheumatica, and visual symptoms. Acute myeloid leukemia (AML) is a hematopoietic stem cell disorder characterized by a block in the differentiation of hematopoiesis, resulting in the growth of a clonal population of neoplastic cells or blasts. This malignant alteration in hematopoietic stem cells leads to a loss of normal hematopoietic function, which, if left untreated, typically leads to death within weeks to months of its clinical presentation. Although there have been reports of CLL or CML accompanied by several kinds of autoimmune vascular diseases, such as polymyalgia rheumatica, GCA, or necrotizing temporal arteritis, no studies have reported a case of AML with GCA. We experienced an 80-year-old male patient who developed AML 6 years after the diagnosis of GCA. He was under the use of oral glucocorticoid, hydroxychloroquine, and methotrexate at the time of the diagnosis of the AML. This is the first case in Korea to report GCA accompanied by AML.

Keyword

Giant cell arteritis; Temporal arteritis; Acute myeloid leukemia

MeSH Terms

Adult
Aged, 80 and over
Arteries
Giant Cell Arteritis
Giant Cells
Headache
Hematopoiesis
Hematopoietic Stem Cells
Humans
Hydroxychloroquine
Jaw
Korea
Leukemia, Myeloid, Acute
Male
Methotrexate
Polymyalgia Rheumatica
Systemic Vasculitis
Vascular Diseases
Hydroxychloroquine
Methotrexate

Figure

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  Figure 1 Cross sections (A, B) of the right superficial temporal artery: Partial destruction of cells by lymphohistiocytic infiltration involving intima, media and adventitia, and histiocytic accumulation at the intimal-medial junction; and fragmentation, degeneration, and dissolution of the internal elastic lamina, consistent with temporal arteritis (A, H&E stain, ×100; B, H&E stain, ×160).

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  Figure 2 Bone marrow aspiration (A) and biopsy (B) show that bone marrow space is packed with increased blasts. Estimated cellularity is nearly 100%, which is hypercellular for the patient's age (A, Wright's stain, ×400; B, H&E stain, ×400).

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