sjögren's syndrome with acute lymphoblastic leukemia: a rare case report

Sjögren's syndrome (ss) is a chronic autoimmune disease with various manifestations involving functional impairment or damage to exocrine gland tissues and extraglandular manifestations. sjögren's syndrome increases the risk of hematological disorders, including leukemia. a 60-year-old woman presented with complaints of weakness, pain, and aches throughout the body, nausea, submandibular lymphadenopathy, and red spots on both legs. she also reported persistent dryness of both eyes with intermittent blurred vision, partially relieved by artificial tears. physical examination revealed slightly pale conjunctiva, dry eyes, multiple erythematous macules on both legs, and bilateral non-pitting edema. hematological examination showed bicytopenia with leukocytosis (hemoglobin 9.9 g/dl, leukocytes 40,400/µl, platelets 113,000/µl) and 29% blast cells. ana profile: anti-ssa +3. the diagnosis of ss was established using the 2016 acr-eular criteria, with positive anti-ssa antibodies (score 3) and a schirmer test result of 5 mm/5 minutes for the right eye (score 1), giving a total score of 4. acute lymphoblastic leukemia (all) was diagnosed based on phenotyping of the peripheral blood sample, which showed markers hla-dr, cd19, cd10, cd20, and morphology consistent with all-l2; conclusion: b-lineage. the patient has sjögren's syndrome, but during the course of the disease, acute lymphoblastic leukemia developed. literature shows that ss has a 156% increased risk of leukemia, but the specific type of leukemia is not mentioned. this is due to the hyperactivity of b cells. this case underscores the rare but critical association between ss and all, not just lymphoma, necessitating vigilant hematological monitoring in these patients.