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Muscle aches and pains: do I have leukemia?

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Abstract

We describe a 65-year-old man who presented with ‘aches and pains’ localized to the lower extremities, and was diagnosed with acute myeloid leukemia (AML). We hypothesize that this case represents an atypical presentation of AML with an immune-mediated necrotizing-like myopathy as a possible paraneoplastic manifestation of the disease, which improved after initiating chemotherapy. Our patient received a full course of 7 + 3 chemotherapy with cytarabine and daunorubicin. Proximal leg weakness and pain improved markedly following this treatment, establishing a temporal relationship between the possible paraneoplastic manifestation and treatment of underlying disease. Associations between malignancy and myopathies such as polymyositis and dermatomyositis have been well established in the literature. However, paraneoplastic IMNM is still a rare clinical phenomenon and has infrequently been associated with AML. This case may suggest myopathy and associated muscle ‘aches and pains’ as possible presenting symptoms of underlying AML, highlighting the heterogeneity of the clinical manifestations of this disease.

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Authors and Affiliations

  1. Department of Medicine, Western University, London, ON, Canada

    Max Deschner, Chai Phua, Lalit Saini, Anargyros Xenocostas & Uday Deotare

  2. Division of Hematology, London Health Sciences Centre, London, ON, Canada

    Chai Phua, Lalit Saini, Anargyros Xenocostas & Uday Deotare

Authors
  1. Max Deschner
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  2. Chai Phua
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  3. Lalit Saini
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  4. Anargyros Xenocostas
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  5. Uday Deotare
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Correspondence to Max Deschner.

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Deschner, M., Phua, C., Saini, L. et al. Muscle aches and pains: do I have leukemia?. Int J Hematol 111, 471–474 (2020). https://doi.org/10.1007/s12185-019-02746-3

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  • DOI: https://doi.org/10.1007/s12185-019-02746-3

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