Chronic Lymphocytic Leukemia: Autoimmune Presentations in A tertiary Care Hospital of Lahore

Abstract

Objective: To determine the frequency of presenting features and complication in chronic lymphocytic leukaemia

Methodology: This descriptive study was conducted at the Hematology department, King Edward Medical University and affiliated hospitals, from July to December 2017. For every patient, a through clinical and dermatological examination, abdominal ultrasound , bone marrow examination was done. Afresh 3 ml blood sample for CBC, immune profile, and serum testing was collected by a syringe using aseptic technique. A complete blood count was carried out using Automated Haematology Analyzer (Sysmex KX-21) and chemical examination was done on Beckman Coulter Beckman coulter. Reticulocyte count was done and direct antiglobulin test using coomb’s reagent was done. Every patient was evaluated for the creteia of SLE and was categorized accordingly.

Results: Out of the 150 patients enrolled in the study, 122(81.3%) were male and 28(18.7%) patients were female. The mean age was 65.8 ± 1.33 years with the majority of patients falling in the group of 71- 80 years. Out of 150 patients, 40 (26.7%) had coombs positive. Most of the patients who had coombs positive were in stage 4. The patients who presented with complications such as paraneoplastic pemphigus were 1 out of 150 patients. Splenomegaly was found in 87.3 % of all CLL patients with 13.33% presented with massive splenomegaly .Angioedema was found in 2 out of 150 patients. No case of SLE, Sjogren s syndrome Churg strauss Syndrome, Vasculitis or Richters Trasnformation was found.

Conclusion: Detection of complications in a significant number of CLL patients is related to disease progression and overall survival. The treatment modalities are different in different causes of anaemia and complications due to CLL. It will help the clinicians in modifying the treatment and decreasing the misery of patients due to  co morbidities.