Nephrotic-range proteinuria in a child with retinoic acid syndrome

Sethna, Christine B.; Reddy, Kiranmye; Levy, Carolyn Fein; Trachtman, Howard

doi:10.1007/s00467-011-2048-x

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Apart from the aforementioned six case reports of APL and nephrotic proteinuria [3,5,[9][10][11], including ours, a comprehensive review of the literature (including terms glomerulonephritis, nephrotic range proteinuria, and NS) allowed us to verify that only six additional cases of non-APL AML subtypes have been reported so far [1,2,4,[6][7][8]. For some reason that we cannot explain, the proportion of cases with APL in all reported AML patients (50%) does not correspond to the incidence of this subtype among AML (7-15%).…”

Section: Discussionmentioning

confidence: 99%

“…The association of proteinuria and malignant hematological disease, although infrequent, is well known, with chronic leukemias, lymphomas, and monoclonal gammopathies the most frequent diseases involved. However, only a few cases of acute myeloid leukemia (AML) have been reported associated with glomerulonephritis so far [1][2][3][4][5][6][7][8][9][10][11]. Interestingly, almost half of the reported cases were acute promyelocytic leukemia (APL), which does not correspond to the proportion of this subtype among AML.…”

Section: Introductionmentioning

confidence: 99%

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Glomerulonephritis Secondary to Acute Promyelocytic Leukemia that Resolved after Induction Therapy

Agamez¹,

Torres

Caceres-Galvis³

et al. 2022

Acta Haematol

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The association of glomerulonephritis and malignant hematological disease is uncommon, but well known in chronic leukemias, lymphomas, and monoclonal gammopathies. However, only a few cases of glomerulonephritis and acute myeloid leukemia has been reported in the literature. We describe the first case of a genetically diagnosed acute promyelocytic leukemia presenting with nephrotic range proteinuria that resolved with induction therapy with ATRA and ATO and performed a comprehensive review of the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Glomerulonephritis Secondary to Acute Promyelocytic Leukemia that Resolved after Induction Therapy

Agamez¹,

Torres

Caceres-Galvis³

et al. 2022

Acta Haematol

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“…Despite beneficial effects and general good tolerability, in some cases, the treatment may be accompanied by a complication known as retinoic acid syndrome (RAS) which also includes acute renal failure [ 5 , 6 ]. This syndrome was described in both adults [ 5 ] and children (a case with signs of nephrotic range proteinuria) [ 7 ]. On the other hand, tissue culture and animal studies show the protective effect of ATRA on the progression of kidney damage [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Retinoic acid associates with mortality of patients on long-term hemodialysis

et al. 2022

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Background Retinol concentrations in serum are significantly higher in patients on hemodialysis (HD) compared to healthy controls. Its lower concentrations have been reported to be an independent predictor of mortality. ATRA – all-trans retinoic acid – is an important compound related to retinol. The objective was to determine ATRA concentrations in serum and to find their association with the prognosis of patients on long-term HD. Methods ATRA was determined by high-performance liquid chromatography in a group of 247 HD patients (follow-up five years) and 54 healthy controls. Results Although serum retinol concentrations were higher in the studied cohort of HD patients, ATRA was lower – median 1.13 (interquartile range 0.90–1.60) ng/mL in HD patients versus 1.42 (1.08–1.63) ng/mL in healthy controls, p = 0.02. Lower ATRA was significantly related to overall mortality of HD patients (HR (95%CI) 0.63 (0.47–0.85) per interquartile range, p = 0.003). The best prognosis was observed in patients with concentrations of both ATRA and retinol above the median ( p = 0.003). Conclusions We detected decreased retinoic acid levels in HD patients compared to healthy controls. Lower concentrations of ATRA represent a significant predictor of mortality and provide additional information to retinol.

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“…A number of mechanisms may explain the rare association between NS and AML. Disruption of podocyte integrity and function due to cytokine release has been proposed as a mechanism of nephrotic syndrome during ATRA-induced differentiation syndrome in APL [ 1 ]. A causal relationship between NS and AML is further supported by the response of proteinuria to chemotherapy for AML and the association between higher leukemia burden and more proteinuria [ 1 , 2 ].…”

mentioning

confidence: 99%

“…Disruption of podocyte integrity and function due to cytokine release has been proposed as a mechanism of nephrotic syndrome during ATRA-induced differentiation syndrome in APL [ 1 ]. A causal relationship between NS and AML is further supported by the response of proteinuria to chemotherapy for AML and the association between higher leukemia burden and more proteinuria [ 1 , 2 ]. Anthracyclines have been proposed as a culprit in the development of NS following treatment of AML since they can cause acute renal tubulointerstitial toxicity [ 3 , 4 ].…”

mentioning

confidence: 99%