A patient with a large granular lymphocytic leukemia may present with a number of clinical and laboratory findings.


Clinical findings:

(1) splenomegaly, which may be marked

(2) skin rash

(3) hepatomegaly

(4) frequent infections

(5) B symptoms (fever, night sweats, weight loss)


Autoimmune paraneoplastic findings:

(1) inflammatory arthropathy, often rheumatoid arthritis (RA)

(2) autoimmune thyroiditis

(3) pure red cell aplasia

(4) immune thrombocytopenic purpura (ITP)

(5) SLE


A patient may develop Felty’s syndrome (RA with marked splenomegaly).


Laboratory findings:

(1) neutropenia

(2) anemia

(3) thrombocytopenia

(4) antinuclear antibodies (ANA)

(5) rheumatoid factor (RF)

(6) beta-2 microglobulinemia

(7) hypergammaglobulinemia

(8) atypical lymphocytosis


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