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