title: Paraneoplastic hypokalemia in acute myeloid leukemia: a case of renin activity in AML blast cells.
abstract: Hypokalemia due to renal potassium loss has frequently been observed in patients with acute myeloid leukemia (AML). The pathogenic mechanism for this hyperkaluresis is unclear. In this report we describe a patient with AML FAB M4, in whom the clinical course, the electrolyte disturbances, the serum aldosterone levels, and the diffuse hyperplasia of the adrenal cortex documented a typical case of marked secondary hyperaldosteronism. On analysis of the leukemic cells of this patient compared with normal bone marrow cells, a significant increase of renin-like activity in the cytosol of the blast cells was noted. Activation of the renin-angiotensin-aldosterone system by paraneoplastic production of renin-like activity in AML blast cells might contribute to the hypokalemia often observed in patients with acute myeloid leukemia.
authors.affiliation: Department of Internal Medicine, Georg-August-Universität, Göttingen, Germany.
authors.forename: G G
authors.initials: GG
authors.lastname: Wulf
authors.forename: G
authors.initials: G
authors.lastname: Jahns-Streubel
authors.forename: F
authors.initials: F
authors.lastname: Strutz
authors.forename: D
authors.initials: D
authors.lastname: Basenau
authors.forename: M
authors.initials: M
authors.lastname: Hüfner
authors.forename: C
authors.initials: C
authors.lastname: Buske
authors.forename: B
authors.initials: B
authors.lastname: Wörmann
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology; D006955:Hypernatremia / Q000209:etiology; D007008:Hypokalemia / Q000209:etiology*; D007951:Leukemia, Myeloid / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D012083:Renin / Q000378:metabolism
chemical_list: D012083:Renin