Sepsis Unveils T-cell Large Granular Lymphocytic Leukemia in the Setting of End-Stage Renal Disease: A Rare Hematologic Malignancy

Tutul Chowdhury; Kalendra Kunwar; Fareeza Mustafa; Annmarie T Sajeev; Mrinal Sharma; Muhammad N Pasha; Madhumati Kalavar

doi:10.7759/cureus.55325

Sepsis Unveils T-cell Large Granular Lymphocytic Leukemia in the Setting of End-Stage Renal Disease: A Rare Hematologic Malignancy

Cureus. 2024 Mar 1;16(3):e55325. doi: 10.7759/cureus.55325. eCollection 2024 Mar.

Authors

Tutul Chowdhury¹, Kalendra Kunwar¹, Fareeza Mustafa¹, Annmarie T Sajeev², Mrinal Sharma¹, Muhammad N Pasha³, Madhumati Kalavar⁴

Affiliations

¹ Internal Medicine, One Brooklyn Health Interfaith Medical Center, New York, USA.
² College of Medicine, American University of Antigua, Jabberwock, ATG.
³ Pulmonary and Critical Care Medicine, One Brooklyn Health Interfaith Medical Center, New York, USA.
⁴ Hematology and Oncology, One Brooklyn Health Interfaith Medical Center, New York, USA.

Abstract

Large granular lymphocytic (LGL) leukemia is a rare chronic lymphoproliferative disorder originating from natural killer cells or T lymphocytes. In this report, we present the case of a 66-year-old female initially treated for sepsis, with methicillin-sensitive Staphylococcus aureus identified on initial blood culture prompting intravenous (IV) antibiotic therapy. The patient met systemic inflammatory response syndrome criteria upon admission due to severe neutropenia. Persistent fever led to neurological symptoms, and imaging revealed lung abnormalities along with chronic changes on the CT scan of the head. Multidisciplinary consultations were sought, resulting in treatment adjustments including antifungals and filgrastim. Flow cytometry and bone marrow biopsy confirmed the diagnosis of LGL leukemia.

Keywords: flow cytometry; leukemia; methicillin-sensitive staphylococcus aureus; neutropenia; sepsis.

Publication types

Case Reports