Probable catastrophic antiphospholipid syndrome secondary to chronic myelomonocytic leukaemia in an adult patient and a mini review

• Published in: Lupus Vol. 29; no. 10; pp. 1287 - 1291
• Main Authors: Meng, Jianfen, Chen, Lijia, Hou, Jiaqi, Chi, Huihui, Wang, Zhihong, Yang, Chengde, Su, Yutong
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2020; Sage Publications Ltd
• Subjects: Anticoagulants; Antiphospholipid syndrome; Autoimmune diseases; Blood cancer; Bone marrow; Case reports; Chronic myelomonocytic leukemia; Hydroxychloroquine; Immunomodulators; Leukemia; Malignancy; Monocytosis; Patients; Peripheral blood; Prednisone; Warfarin; Chronic myelomonocytic leukaemia; catastrophic antiphospholipid syndrome; antiphospholipid antibodies
• ISSN: 0961-2033; 1477-0962; 1477-0962
• DOI: 10.1177/0961203320937349

Catastrophic antiphospholipid syndrome (CAPS) is a rare and life-threatening form of antiphospholipid syndrome (APS), which could be triggered by malignancy. Chronic myelomonocytic leukaemia (CMML) is an uncommon hematologic malignancy. We report a case of a 49-year-old male patient who presented multiple thromboses with a high titre of anti-β2-glycoprotein-I antibody. Unexpectedly, there was persistent monocytosis combined with <20% blasts in his bone marrow. Thus, a diagnosis of probable CAPS and CMML was made. After treatment with prednisone, hydroxychloroquine and warfarin, the thromboses dissolved, and an improved presentation of peripheral blood and bone marrow was observed. Here, we also provide a mini review of cases of APS complicated with CMML identified from searches of MEDLINE, EMBASE and Web of Science databases. The review describes the clinical characteristics, laboratory data, treatments and outcomes.