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Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient

Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case o...

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Autores principales: Caballero, Juan Carlos, Askari, Elham, Carrasco, Nerea, Piris, Miguel Angel, Perez de Camino, Begoña, Pardo, Laura, Cornago, Javier, Lopez-Lorenzo, Jose Luis, Llamas, Pilar, Solan, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135538/
https://www.ncbi.nlm.nih.gov/pubmed/37189625
http://dx.doi.org/10.3390/biomedicines11041007
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author Caballero, Juan Carlos
Askari, Elham
Carrasco, Nerea
Piris, Miguel Angel
Perez de Camino, Begoña
Pardo, Laura
Cornago, Javier
Lopez-Lorenzo, Jose Luis
Llamas, Pilar
Solan, Laura
author_facet Caballero, Juan Carlos
Askari, Elham
Carrasco, Nerea
Piris, Miguel Angel
Perez de Camino, Begoña
Pardo, Laura
Cornago, Javier
Lopez-Lorenzo, Jose Luis
Llamas, Pilar
Solan, Laura
author_sort Caballero, Juan Carlos
collection PubMed
description Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case of a 77-year-old woman diagnosed with WM following the development of severe and sudden pancytopenia associated with a cold agglutinin syndrome. In order to treat the WM and the underlying hemolysis, treatment with rituximab, corticosteroids and cyclophosphamide was started. Despite the improvement in hemolysis parameters, pancytopenia persisted, and we started a second line with ibrutinib. During treatment the patient developed an uncommon invasive fungal infection (IFI) with bone marrow granulomatosis and myelofibrosis. This case shows an unusual clinical course with a poor hematopoietic response to treatment and a large number of intercurrent complications.
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spelling pubmed-101355382023-04-28 Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient Caballero, Juan Carlos Askari, Elham Carrasco, Nerea Piris, Miguel Angel Perez de Camino, Begoña Pardo, Laura Cornago, Javier Lopez-Lorenzo, Jose Luis Llamas, Pilar Solan, Laura Biomedicines Case Report Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case of a 77-year-old woman diagnosed with WM following the development of severe and sudden pancytopenia associated with a cold agglutinin syndrome. In order to treat the WM and the underlying hemolysis, treatment with rituximab, corticosteroids and cyclophosphamide was started. Despite the improvement in hemolysis parameters, pancytopenia persisted, and we started a second line with ibrutinib. During treatment the patient developed an uncommon invasive fungal infection (IFI) with bone marrow granulomatosis and myelofibrosis. This case shows an unusual clinical course with a poor hematopoietic response to treatment and a large number of intercurrent complications. MDPI 2023-03-24 /pmc/articles/PMC10135538/ /pubmed/37189625 http://dx.doi.org/10.3390/biomedicines11041007 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Caballero, Juan Carlos
Askari, Elham
Carrasco, Nerea
Piris, Miguel Angel
Perez de Camino, Begoña
Pardo, Laura
Cornago, Javier
Lopez-Lorenzo, Jose Luis
Llamas, Pilar
Solan, Laura
Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title_full Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title_fullStr Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title_full_unstemmed Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title_short Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient
title_sort invasive cutaneous candidiasis, autoimmune hemolytic anemia and pancytopenia: a challenging scenario for waldenström macroglobulinemia in an elderly patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135538/
https://www.ncbi.nlm.nih.gov/pubmed/37189625
http://dx.doi.org/10.3390/biomedicines11041007
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