title: Acute renal failure due to leukemic cell infiltration followed by relapse at multiple extramedullary sites in a child with acute lymphoblastic leukemia.
abstract: Acute renal failure due to leukemic infiltration into the kidney is rare in childhood acute lymphoblastic leukemia (ALL). We report here a five year-old boy with ALL who presented acute renal failure caused by leukemic infiltration at onset. Treatment with predonisolone and hemodialysis was effective. However, he showed persistent or repeated relapses at extramedullary sites, such as central nervous system, testis, and pancreas, suggesting that leukemic cells of this patient may have had a high affinity to extramedullary organs. On the basis of previous reports and the experience of this patient, intensive treatment may be needed in ALL children with renal involvement.
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sato
authors.forename: Masue
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Shuji
authors.initials: S
authors.lastname: Chikaoka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Niizuma
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hoshi
authors.forename: Junji
authors.initials: J
authors.lastname: Takeyama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Fujii
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nishio
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Chihaya
authors.initials: C
authors.lastname: Maesawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kazuie
authors.initials: K
authors.lastname: Iinuma
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D001402:B-Lymphocytes / Q000473:pathology; D002675:Child, Preschool; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D007668:Kidney / Q000473:pathology; D017254:Leukemic Infiltration / Q000150:complications*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D012008:Recurrence