Acute interstitial nephritis in T-cell leukemia in a pediatric patient.
Acute lymphoid leukemia is the most frequently occurring malignancy in childhood, but acute tubulointerstitial nephritis with associated acute renal failure as the leading manifestation of leukemia is extremely rare. Only a few pediatric cases have been described in the literature. We present a surprising case in which physical examination and initial investigation were not typical for leukemia. Ultrasound showed only modest kidney enlargement while laboratory results indicated acute renal failure. Renal biopsy indicated tubulointerstitial nephritis, and subsequent steroid treatment led to sudden clinical improvement. One month later, however, the patient returned with typical clinical features of leukemia. Re-evaluation of the original kidney biopsy block indicated T-cell acute lymphoid leukemia. The present case highlights the importance of renal biopsy.
Department of Pediatrics, University and Clinical Center of Debrecen, Debrecen, Hungary.
Erika
http://orcid.org/0000-0001-5315-4298
E
Biro
Department of Pediatrics, University and Clinical Center of Debrecen, Debrecen, Hungary.
Edit
E
Szikszay
Department of Pediatrics, University and Clinical Center of Debrecen, Debrecen, Hungary.
Petronella
P
Pethő-Orosz
Department of Pathology, University and Clinical Center of Debrecen, Debrecen, Hungary.
László
L
Bigida
Department of Pediatrics, University and Clinical Center of Debrecen, Debrecen, Hungary.
György
G
Balla
Department of Pediatrics, University and Clinical Center of Debrecen, Debrecen, Hungary. szabota68@gmail.com.
Tamás
T
Szabó
D001706:Biopsy; D002648:Child; D006801:Humans; D007684:Kidney Tubules / Q000473:pathology*; D007938:Leukemia / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology*; D013601:T-Lymphocytes / Q000473:pathology*
T-cell leukemia; acute kidney injury; child; dialysis; interstitial nephritis