Rose Ashley, Slone Samuel, Padron Eric
Internal Medicine, University of South Florida, Tampa, FL 33602, USA.
Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33602, USA.
Case Rep Nephrol. 2019 May 13;2019:7913027. doi: 10.1155/2019/7913027. eCollection 2019.
Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults. It is an aggressive hematologic neoplasm, with a bimodal age distribution typically presenting in childhood and the 6 decade of life (Terwilliger and Abdul-Hay, 2017). Renal injury in ALL is common and can occur through many different mechanisms, such as prerenal acute kidney injury, acute tubular necrosis, renovascular disease, obstruction, glomerulonephritis, and parenchymal infiltration of tumor cells (Luciano and Brewster, 2014). Infiltration of kidneys by leukemia cells is common; however a resultant injury only occurs in about 1% of patients, and renal failure is even more rare (Luciano and Brewster, 2014). Renal failure due to bilateral infiltration of tumor cells has been reported in only a few cases and is thought to be a poor prognostic indicator (Luciano and Brewster, 2014; Sherief et al., 2015). Biopsy is essential to the diagnosis of renal infiltration of leukemia. We present a case of acute renal failure secondary to bilateral renal infiltration of ALL presenting as the first sign of relapse in a young man.
急性淋巴细胞白血病（ALL）是成人中第二常见的急性白血病。它是一种侵袭性血液肿瘤，具有双峰年龄分布，通常发生在儿童期和60岁左右（特尔维利格和阿卜杜勒 - 海，2017年）。ALL患者的肾损伤很常见，可通过多种不同机制发生，如肾前性急性肾损伤、急性肾小管坏死、肾血管疾病、梗阻、肾小球肾炎以及肿瘤细胞的实质浸润（卢西亚诺和布鲁斯特，2014年）。白血病细胞浸润肾脏很常见；然而，由此导致的损伤仅发生在约1%的患者中，肾衰竭更为罕见（卢西亚诺和布鲁斯特，2014年）。仅在少数病例中报道过肿瘤细胞双侧浸润导致的肾衰竭，被认为是不良预后指标（卢西亚诺和布鲁斯特，2014年；谢里夫等人，2015年）。活检对于白血病肾浸润的诊断至关重要。我们报告一例年轻男性因ALL双侧肾浸润继发急性肾衰竭，表现为复发的首发症状。
