Spapen Jerrold, Fostier Karel, De Raeve Hendrik, Janssens Peter, Spapen Herbert
Department of Internal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Hematology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Int J Nephrol Renovasc Dis. 2015 Dec 21;9:1-4. doi: 10.2147/IJNRD.S98528. eCollection 2016.
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.
急性肾衰竭可能使血液系统恶性肿瘤的病程复杂化，但在慢性粒单核细胞白血病患者中是极不常见的表现。在此情况下很少进行肾活检，肾损伤的病理基础也尚未明确。我们报告一例经活检证实的急性肾小管间质性肾炎，病因是肿瘤性粒单核细胞大量浸润。由于累及肾脏的白血病过程可能对治疗有良好反应，对于任何出现不明原因的严重或进展性肾病的患者，都应考虑进行肾活检。
