Large Granular Lymphocytic Leukemia (LGLL) can be associated with a number of autoimmune disorders, especially rheumatoid arthritis (RA). A number of clues may help to identify the patient with rheumatoid arthritis who has LGLL.
Patient selection: rheumatoid arthritis
Clues to the presence of LGLL:
(1) absolute neutropenia
(2) moderate to severe anemia
(3) splenomegaly and/or Felty’s syndrome (splenomegaly and neutropenia)
(4) other autoimmune disorders
(5) chronic atypical lymphocytosis, especially with granular lymphocytes
(6) recurrent infections not explained by other cause
Flow cytometry of the peripheral blood can help to establish the diagnosis.
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