Sureka S K, Yadav P, Kumar P, Srivastava A
Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India.
Department of Haematology, SGPGIMS, Lucknow, Uttar Pradesh, India.
Indian J Nephrol. 2018 Mar-Apr;28(2):153-156. doi: 10.4103/ijn.IJN_54_17.
A 46-year-old male presented with left flank pain and was found to have left nephromegaly with renal vein and inferior vena cava (IVC) thrombus. On hematological evaluation, he had leukocytosis and thrombocytopenia. Further evaluation revealed acute myeloid leukemia (AML). Following initial cytoreductive therapy and supportive care for hyperleukocytosis, he underwent left simple nephrectomy with IVC thrombectomy. Postoperatively, he developed massive thrombosis of infrahepatic IVC with renal failure. Renal venous thrombosis as a rare presentation of AML in adults with leukemic hyperleukocytosis has not been reported. In the absence of clear guidelines, early diagnosis and management are desirable.
一名46岁男性因左侧腰痛就诊,检查发现左肾肿大并伴有肾静脉及下腔静脉血栓形成。血液学评估显示他存在白细胞增多和血小板减少。进一步检查发现急性髓系白血病(AML)。在接受初始细胞减灭治疗及针对白细胞增多的支持治疗后,他接受了左肾单纯切除术及下腔静脉血栓切除术。术后,他出现肝下下腔静脉大量血栓形成并伴有肾衰竭。肾静脉血栓形成作为成人白血病性白细胞增多症中AML的一种罕见表现尚未见报道。由于缺乏明确的指导方针,早期诊断和管理很有必要。