title: An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Jerrold
authors.initials: J
authors.lastname: Spapen
authors.affiliation: Department of Hematology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Fostier
authors.affiliation: Department of Pathology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Hendrik
authors.initials: H
authors.lastname: De Raeve
authors.affiliation: Department of Nephrology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Janssens
authors.affiliation: Department of Intensive Care Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Herbert
authors.initials: H
authors.lastname: Spapen
keywords: acute tubulo-interstitial nephritis; chronic myelomonocytic leukemia; kidney biopsy; treatment