Isolated Cutaneous Chronic Lymphocytic Leukemia: A Case Report.

Skin lesions in chronic lymphocytic leukemia (CLL) have been reported in between 4% and 20% of patients with CLL and are a rare entity compared with T-cell leukemia. They can present mainly as leukemic cutis or, frequently, as secondary lesions such like urticaria, itching, pyoderma gangrenosum, cutaneous vasculitis, Sweet's syndrome, and erythroderma. We report on an adult patient who developed a skin lesion of forearms and hands, leading to the discovery of isolated cutaneous CLL after two biopsies. Isolated CLL cutaneous location is very rare and may be diagnosed late, as in the case of our patient. A better knowledge of the course of the illness and rapid diagnosis of this CLL cutis leukemia will enhance the therapeutic efficacy of the disease.

A Case of Acquired Aplastic Anemia after Severe Hepatitis- Probably Induced by the Pfizer/BioNTech Vaccine: A Case Report and Review of Literature.

INTRODUCTION: An important but rare adverse effect of vaccines is their association with autoimmune events, including hepatitis and aplastic anemia (AA). In this paper, we report a case of hepatitis followed by AA that occurred after the COVID-19 vaccine was administered. CASE REPORT: This paper focuses on a 30-year-old female who presented with acute hepatitis three weeks after receiving the second dose of the coronavirus Pfizer/BioNTech vaccine. After an extensive diagnostic evaluation was conducted that did not discover a specific cause, the Pfizer/BioNTech vaccine was suspected and the patient was treated with corticosteroids. One week after the onset of a liver disorder, the patient presented with gum bleeding and pancytopenia, and the diagnosis of AA was established via laboratory testing and bone marrow biopsy. After the diagnosis, the patient received immunosuppressive therapy using anti-lymphocyte serum (ATGAM) and CYCLOSPORINE A with progressive improvements in cytopenia. The important issue is whether AA is related to acute hepatitis or the coronavirus vaccine. CONCLUSION: Clinicians should be aware of the risk of both the possibility of acute hepatitis, AA, or both after receiving the COVID-19 vaccination. It is very hard to distinguish the cause of AA between vaccine- and hepatitis-related AA. Predicting who develops hepatic or myelo-complications after vaccination is difficult.

Autoimmune hemolytic anemia revealing classical Hodgkin lymphoma: Two case reports and literature review

BACKGROUND: Hodgkin Lymphoma (HL) is rarely associated with autoimmune hemolytic anemia. We report here two cases of such association: Case 1: 57 years old man who presented with tiredness and pallor. Physical examination revealed multiple left cervical lymph nodes. Blood count showed regenerative macrocytic anemia with signs of hemolysis. Auto immune hemolytic anemia was confirmed by a positive direct antiglobulin test for IgG and C3d; lymph node biopsy revealed lymphocytic rich HL. Case 2: a 50 year old man being treated for HL for few months presented to the emergency room for dyspnea and pallor. Blood count showed regenerative macrocytic anemia with positive direct antiglobulin test for IgG and C3d confirming the diagnosis of AIHA as a relapse of the lymphoma. These two cases show that clinicians should be aware of such association revealing the diagnosis or the relapse of the lymphoma to distinguish it from anemia of chronic disease.