Concurrent Inflammatory Bowel Disease and Myelodysplastic Syndrome: Report of Nine New Cases and a Review of the Literature

Abstract

Nine patients with concurrent myelodysplastic syndrome (MDS) and inflammatory bowel disease (IBD) were examined. Median age at diagnosis of these patients was similar to the usual age of patients at diagnosis of IBD only. There was a strong predominance of Crohn's disease (seven of nine cases), with an unusually high frequency of colorectal involvement (five of nine cases). Inflammatory bowel disease was diagnosed first in one patient, MDS first in five patients, and both diseases were diagnosed simultaneously in three patients. All patients had moderate or severe anemia. The prognosis of IBD was determined by MDS. These observations suggest that there is an unclear common pathogenesis of IBD and MDS and, consequently that patients with IBD and anemia of non-obvious origin should be evaluated for the presence of MDS.

Paraneoplastic inflammation in myelodysplastic syndrome or bone marrow failure: case series with focus on 5‐azacytidine and literature review

“…In case #1 and #4, intensive immunosuppression was necessary to gain control of the autoimmune symptoms. These cases queue themselves into a number of reported cases with MDS associated with systemic inflammation with or without haemophagocytic lymphohistiocytosis, vasculitis, rheumatoid arthritis, rheumatoid dermatitis, pyoderma gangraenosum, inflammatory bowel disease and systemic lupus as the index paraneoplastic inflammatory disorder .…”

Ulcerative Colitis in Hematological Malignancies: Paraneoplastic Manifestation or Coincidental Bystander?

“…A rather serious turmoil has been created with respect to hematological malignancies complicating inflammatory bowel disease (IBD), and although data from large studies indicate an increased risk for UC patients to develop myeloid leukemia, it is not yet clear whether the disease itself or the different therapeutic agents used are to be held accountable [1,4]. In contrast, little is known about the prevalence of IBD in patients with hematopoietic malignancies [1][2][3] while the notion that UC may represent a paraneoplastic manifestation in such cases is "terra incognita." Motivated by the admission in our tertiary center, during a 2½-year period, of three patients with three different hematological malignancies accompanied by UC at an almost identical extent and severity, it seemed fit to further examine this association.…”

“…Moreover, the biological pathways involved in hematological malignancies and UC are interlinked, with several mediators of inflammation and cellular populations with an altered response profile being shared among these entities [8]. Indeed, tumor necrosis factor-alpha (TNF-α), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), interleukins (IL-1, -5, -6, and -8), angiogenesis factors (i.e., vascular endothelial growth factor (VEGF)), irregular plasmatoid cells inducing pronounced TNF-α and reduced interferon-gamma production, and eosinophils are key-components of the pathogenesis of MM, MDS, SM, and UC [3,[7][8][9][10][11][12]. Further details pertaining to each case are also presented below.…”

“…e term "paraneoplastic" has been coined to describe a series of manifestations resulting from biologically active substances or immune responses, induced by solid tumors or hematological malignancies. Evidence of coexistence of diverse hematological malignancies-lymphoma, leukemia, multiple myeloma, and myelodysplastic syndromes-and either ulcerative colitis (UC) or Crohn's disease (CD) can be found in the literature [1][2][3]. However, a more "systemic" effort to reach further and examine the potential of either one as potential paraneoplastic manifestation has not been performed.…”

Stress and Non-Stress Roles of Inflammatory Signals during HSC Emergence and Maintenance

“…In addition, it was reported that inflammatory bowel disease patients were diagnosed with MDS. Both these studies suggest an association between MDS and inflammation (107). However, it is still not clear whether inflammation precedes MDS or vice versa.…”