title: [Renal insufficiency caused by leukemic cell infiltration in Sézary syndrome].
abstract: A 77-year-old woman was admitted to our hospital because of pneumonia and heart failure in July 2002. She had been diagnosed as having with Sézary syndrome in 1993, and had been treated with a combination of prednisolone, methotrexate, and cyclosporin A with subsequent stable disease but persistent generalized erythroderma. On admission, the white blood count was 23.9 X 10(9)/L with 28% Sézary cells, and serum creatinine levels were within normal limits. One month after admission, the pneumonia and heart failure improved remarkably with antibiotics and diuretics. However, at the same time, her renal function deteriorated with increasingly high serum creatinine levels. She died of anuria in September, 2002. An autopsy showed marked perivascular and peritubular infiltration of abnormal lymphocytes with degenerative nephrotubuli in the kidneys. This patient may be the first reported case of Sézary syndrome with renal failure caused by leukemic infiltration.
authors.affiliation: Departments of Hematology and Clinical Immunology, Laboratory Medicine, Kobe City General Hospital.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagai
authors.forename: Minako
authors.initials: M
authors.lastname: Tani
authors.forename: Naoko
authors.initials: N
authors.lastname: Watanabe
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurata
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsushita
authors.forename: Akinori
authors.initials: A
authors.lastname: Maeda
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamashita
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Shirane
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007684:Kidney Tubules / Q000473:pathology*; D017254:Leukemic Infiltration / Q000150:complications*; D009336:Necrosis; D051437:Renal Insufficiency / Q000209:etiology*; D012751:Sezary Syndrome / Q000150:complications* / Q000473:pathology*; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology*