International Journal of Nephrology and Renovascular Disease (Dec 2015)
An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration
Abstract
Jerrold Spapen,1 Karel Fostier,2 Hendrik De Raeve,3 Peter Janssens,4 Herbert Spapen51Department of Internal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 2Department of Hematology, 3Department of Pathology, 4Department of Nephrology, Universitair Ziekenhuis Brussel, 5Department of Intensive Care Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, BelgiumAbstract: Acute renal failure may complicate the course of a hematologic malignancy but is a highly unusual finding in patients with chronic myelomonocytic leukemia. Kidney biopsy is rarely performed in this setting, and the pathologic substrate underlying kidney injury is not well identified. We present a case of a biopsy-proven acute tubulo-interstitial nephritis due to massive infiltration of neoplastic myelomonocytic cells. Since the leukemic process involving the kidney may respond favorably to treatment, a renal biopsy should be considered in any patient presenting with unexplained severe or evolving kidney disease.Keywords: chronic myelomonocytic leukemia, acute tubulo-interstitial nephritis, kidney biopsy, treatment
