A Forgotten Cause of Kidney Injury in Chronic Myelomonocytic Leukemia

Patel, Tejas; Rennke, Helmut G.; Sloan, J. Mark; DeAngelo, Daniel J.; Charytan, David M.

doi:10.1053/j.ajkd.2008.11.013

Cited by 39 publications

(36 citation statements)

References 26 publications

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“…5 Finally, one case of acute renal failure secondary to tumor lysis after treatment with hydroxycarbamide and one case of tubular injury due to increased production and excretion of lysozyme were reported. 3,7 The combination of interstitial inflammation, tubulitis, and degenerative tubular changes in the absence of vascular or glomerular damage confirmed the diagnosis of ATIN in our patient. Differential diagnosis of ATIN is extensive.…”

Section: Discussionsupporting

confidence: 82%

“…Common causes include parenchymal infiltration by malignant cells, intrarenal leukostasis, tumor lysis syndrome, thrombotic microangiopathy, cryoglobulinemia, paraprotein deposition disease, chemotherapy-induced tubular or vascular toxicity, radiation injury, and ureteral obstruction from lymphadenopathy. 3 Intrinsic renal involvement, though uncommon, is more likely to be encountered in CMML than in other forms of myelodysplasia. 4 The scarce reports of biopsy-proven CMML-associated renal dysfunction mostly describe extracapillary or membranous glomerulonephritis and amyloid deposition.…”

Section: Discussionmentioning

confidence: 99%

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An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration

Spapen¹,

Fostier²,

Raeve³

et al. 2015

IJNRD

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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.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration

Spapen¹,

Fostier²,

Raeve³

et al. 2015

IJNRD

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show abstract

“…The most frequent among them are described in this section and other potential causes are listed in Table 2 [32,[37][38][39][40][41][42][43][44][45][46][47][48][49].…”

Section: Underlying Causes Of Acute Kidney Injurymentioning

confidence: 99%

“…Lysozyme [43] Reported in some patients with chronic myelomonocytic leukemia or acute monocytic leukemia. Small cationic protein that leads to acute proximal tubular injury.…”

Section: Rare (Case Reports)mentioning

confidence: 99%

Acute kidney injury in hematological patients

Canet

Vincent

Darmon³

et al. 2015

Current Opinion in Critical Care

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“…Individuals who have a poor response to TLS treatment should be assessed for the rarer causes of AKI, including direct leukaemic infiltration of the kidney, amyloid deposition, lysozyme deposition and vasculitis 12 13. This again highlights the importance of involving renal physicians, as these pathologies would require renal biopsy for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous tumour lysis syndrome secondary to the transformation of chronic myelomonocytic leukaemia into acute myeloid leukaemia

2016

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A 78-year-old man, with a 6-year history of stable chronic myelomonocytic leukaemia (CMML), presented with general deterioration and worsening pancytopenia. Bone marrow biopsy showed that his disease had transformed into acute myeloid leukaemia (AML). He was started on a supportive transfusion regimen and did not receive any chemotherapy or corticosteroids. Several weeks later, he developed acute renal failure and was admitted to a medical admissions ward. Spontaneous tumour lysis syndrome (sTLS, grade 1) was diagnosed, as per the Cairo and Bishop criteria. He was treated with intravenous fluids, rasburicase and allopurinol. His renal function improved and he recovered from the sTLS. The authors believe that this is the first published case of sTLS occurring as a result of CMML transforming into AML; it highlights the importance of recognising sTLS as a cause of renal failure and electrolyte disturbance before cancer treatment begins.

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A Forgotten Cause of Kidney Injury in Chronic Myelomonocytic Leukemia

Cited by 39 publications

References 26 publications

An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration

An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration

Acute kidney injury in hematological patients

Spontaneous tumour lysis syndrome secondary to the transformation of chronic myelomonocytic leukaemia into acute myeloid leukaemia

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