Systemic Lupus Erythematosus and Acute Myeloid Leukemia: Coexistence, Diagnosis and Therapeutic Challenges

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems and characterized by systemic inflammation. Acute myeloid leukemia (AML) is an aggressive hematological malignancy marked by the clonal proliferation of immature myeloid cells in the bone marrow.

Case presentation: We report the case of a 35-year-old male with a known diagnosis of SLE who presented with general deterioration including fatigue, anorexia, a 15 kg weight loss over two months and fever (38.5°C), along with a perianal abscess. Laboratory investigations revealed pancytopenia with a hemoglobin level of 5.4 g/dL, WBC count of 2,600/mm³ and platelets at 16,000/mm³. Peripheral blood smear showed 55% blast cells. Bone marrow aspiration confirmed AML with Auer rods and translocation t(8;21). Management included empirical antibiotic therapy, antifungal prophylaxis, corticosteroids for SLE flare, followed by referral to hematology for chemotherapy. The patient responded well clinically and biologically.

Conclusion: The coexistence of SLE and AML is rare and poses complex diagnostic and therapeutic challenges. This case emphasizes the importance of a multidisciplinary approach and heightened clinical vigilance.