J Korean Rheum Assoc.  2010 Dec;17(4):417-421. 10.4078/jkra.2010.17.4.417.

A Case of Ankylosing Spondylitis Accompanied by Chronic Myelogenous Leukemia

• Choi WH
• Ji EH
• Lee JH
• Kim SW
• Min JS
• Park HW
• Jun BY
• Jeong YO
• Park KS
• Park SH
• Kim HY

• KMID: 2201901
• DOI: http://doi.org/10.4078/jkra.2010.17.4.417

Abstract

Ankylosing spondylitis (AS) is occasionally accompanied by hematological malignancies such as myelodysplastic syndrome, acute myelogenous leukemia, or multiple myeloma. Chronic myelogenous leukemia (CML) is a myeloproliferative disorder associated with Philadelphia chromosome and is usually treated with imatinib, which inhibits tyrosine kinases. Although there have been reports of CML cases accompanied by several rheumatic diseases such as rheumatoid arthritis, Behcet's disease, systemic sclerosis, or undifferentiated spondylopathy, no studies have reported a case of CML with AS. We experienced a 50-year-old male patient who presented with buttock and low back pain and was diagnosed with both AS and CML. Magnetic resonance imaging showed sacroiliitis along with abnormal marrow infiltration, and a bone marrow biopsy confirmed the CML diagnosis. He was treated with imatinib, which was effective for the CML but not for the AS. This is the first case report of AS accompanied by CML.

Keyword

Ankylosing spondylitis; Chronic myelogenous leukemia; Imatinib

MeSH Terms

Arthritis, Rheumatoid
Benzamides
Biopsy
Bone Marrow
Buttocks
Hematologic Neoplasms
Humans
Imatinib Mesylate
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid, Acute
Low Back Pain
Magnetic Resonance Imaging
Male
Middle Aged
Multiple Myeloma
Myelodysplastic Syndromes
Myeloproliferative Disorders
Philadelphia Chromosome
Phosphotransferases
Piperazines
Pyrimidines
Rheumatic Diseases
Sacroiliitis
Scleroderma, Systemic
Spondylitis, Ankylosing
Tyrosine
Benzamides
Phosphotransferases
Piperazines
Pyrimidines
Tyrosine

Figure

• 

  Fig. 1. Bone scan (posterior view of the pelvis) shows increased radio-uptakes in both sacroiliac joints.

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  Fig. 2. (A) T2-weighted fat suppression magnetic imaging shows high signal intensity in both sacroiliac joints (black arrows) and bone marrow edema in the left sacroiliac joint. Additionally, abnormal bone marrow infiltrations are present in the femurs (white arrows) and the pelvic bones. (B) T1-weighted imaging clearly shows abnormal bone marrow infiltrations in the femur (arrows) and the pelvic bones.

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  Fig. 3. Bone marrow aspiration smear shows hypercellularity and increased granulocyte precursors (Wright's stain, ×400).

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