Paraneoplastic Pemphigus With Corneal Melt Leading to Evisceration in a Patient With Chronic Lymphocytic Leukemia: Navigating Immunosuppression and Disease Control (SOHO 2026) - Sep 1, 2026 - Abstract #CLL-1425; "Case Report: A 60-year-old man was diagnosed with immunoglobulin heavy chain variable region (IGHV)-unmutated, TP53 wild-type CLL in 2020 and remained on active surveillance until 5 years later, when progressive PNP prompted initiation of venetoclax-obinutuzumab along with immunosuppression using prednisone, cyclosporine, and upadacitinib...Despite repeated corneal glue applications, methylprednisolone, intravenous immunoglobulins (IVIG), and cyclophosphamide, he developed complete corneal melt with active uveal prolapse and markedly elevated intraocular pressure...Therapy was transitioned to acalabrutinib to leverage Bruton tyrosine kinase (BTK) inhibition for sustained CLL control alongside favorable T-cell immunomodulatory effects relevant to PNP pathogenesis...Escalation to higher dose upadacitinib with the addition of ruxolitinib is under consideration given its broader JAK inhibition profile... This case highlights the catastrophic and underappreciated..."
Clinical • Chronic Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • IGH • TP53
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Ruben Ruiz Vega MD; Oscar Borja-Montes MD; Omar Bishr MD; Jack Burcher DO; Majed Al-Nazer MD; Muhammad Tariq MD
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