35-year-old patient with chronic myelogenous leukemia developing systemic lupus erythematosus after α-interferon therapy

✍ Scribed by Nilesh D. Mehta; Arthur L. Hooberman; Everett E. Vokes; Scott Neeley; Scott Cotler

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 130 KB
• Volume: 41
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830410215

✦ Synopsis

The maculopapular rash recurred in December 1990, associated with fever, severe arthralgias, and headaches. Alpha-interferon was discontinued out of concern that it may be exacerbating the patient's condition.

She was admitted to the University of Chicago in January 1991 for evaluation of worsening rash and fever. On physical examination, her temperature was 38.2"C. A blanching maculopapular rash was present over the malar areas of her face, trunk, and limbs. Upper extremity lesions were concentrated over the elbows. Musculoskeletal examination revealed tenderness and swelling of metacatpophalangeal joints bilaterally. The rest of her physical examination was normal except for splenomegaly, which was unchanged.

Laboratory examination revealed a hematocrit of 35.4%; white count was 7,900 with 93% polys, 4% bands, and 1 % lymphocytes. Liver function abnormalities included an alkaline phosphatase of 246 (normal: 33-13 1 IU) and a SGOT of 40 IU (normal <35). An anti-nuclear antibody was elevated at 200 (nl 0-50) with a speckled pattern, double stranded DNA titer was