CML with extrapulmonary tuberculosis with secondary HLH associated with deep vein thrombosis

Abstract Background Tuberculosis may complicate imatinib therapy in patients with chronic myeloid leukemia. However, synchronous presentation of tuberculosis and CML is rare. Malignancy is a hypercoagulable state, especially in those who present with hyperleukocytosis and thrombocytosis. Purpose Still, the presentation of CML with deep vein thrombosis after 2 months of initiation of tyrosine kinase inhibitor therapy is rare. Methods We present a case of a young female who presented with prolonged intermittent episodes of low-grade fever, abdominal distension, and cough. Diagnostic workup confirmed the simultaneous presence of peritoneal tuberculosis and CML in the chronic phase. Results Two months after starting the antitubercular drug and imatinib, she developed unilateral deep vein thrombosis of the right lower limb, which was possibly due to the underlying malignancy, as evaluation for other causes of thrombophilia was negative. Conclusions We report this case of extrapulmonary tuberculosis preceding the diagnosis of CML with atypical complications during treatment, which made the management of the disease challenging.