Ras-Associated Autoimmune Leukoproliferative Disorder Manifesting in an Adult Patient as a Lupus-Like Syndrome and Demonstrating Bone Marrow and Peripheral Blood Findings Reminiscent of Chronic Myelomonocytic Leukemia

Ras-associated autoimmune leukoproliferative disorder (RALD) is a rare, clonally derived leukoproliferative disorder that often affects the pediatric population and can show a variety of systemic, autoimmune symptoms. We describe an adult RALD patient clinically presenting with a lupus-like syndrome and demonstrating bone marrow and peripheral blood findings reminiscent of chronic myelomonocytic leukemia (CMML). This challenging presentation of a rare disease highlights the difficulty in recognizing RALD in adults, a distinction that can have significant treatment implications.