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Rare disease
CASE REPORT
An atypical presentation of Sweet’s syndrome in a myelofibrosis patient
  1. Umera Thebo1,
  2. Sirisha Tummala2,
  3. Samah Nassereddine3 and
  4. Faysal Haroun4
  1. 1 Hematology and Oncology, George Washington University, Washington, DC, USA
  2. 2 George Washington University School of Medicine and Health Sciences, Washington, DC, USA
  3. 3 Internal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
  4. 4 George Washington University, Washington, DC, USA
  1. Correspondence to Dr Umera Thebo, umerathebo{at}gwu.edu

Abstract

A 46-year-old man with no significant medical history presented to haematology with symptoms of fatigue, dyspnoea on exertion and weight loss. Physical examination revealed a lesion on the right shin and splenomegaly. Labs were significant for leucocytosis with immature components, thrombocytosis and 3% peripheral blasts on smear. A bone marrow biopsy confirmed a diagnosis of myelofibrosis (MF). Dynamic International Prognosis Scoring system was 2. He was started on ruxolitnib, with decitabine added subsequently prior to definitive therapy with an allogenic haematopoietic stem cell transplant. His course with decitabine was complicated with febrile neutropaenia with multiple tender erythematous plaques unresponsive to antibacterial and antifungal coverage. A skin biopsy showed neutrophilic dermatitis, consistent with a diagnosis of Sweet’s syndrome (SS) and empirical treatment with glucocorticoids was initiated resulting in resolution of symptoms. This report reviews the literature for cases of SS in the setting of MF.

  • cancer intervention
  • haematology (drugs and medicines)
  • malignant disease and immunosuppression
  • cancer - see oncology

http://dx.doi.org/10.1136/bcr-2018-228076

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    Footnotes

    • Contributors All authors (UT, ST, SN and FH) contributed towards the planning and design of the case report. SN and UT collected the data. UT designed the table and collected pathology images.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.