慢性淋巴细胞白血病中白血病浸润所致的肾衰竭。
Renal failure caused by leukaemic infiltration in chronic lymphocytic leukaemia.
作者信息
Phillips J K, Bass P S, Majumdar G, Davies D R, Jones N F, Pearson T C
机构信息
Department of Haematology, St Thomas's Hospital, London.
出版信息
J Clin Pathol. 1993 Dec;46(12):1131-3. doi: 10.1136/jcp.46.12.1131.
Abstract
A case of B-CLL which was complicated by chronic renal failure due to leukaemic infiltration of the kidney is reported. Treatment with chlorambucil, prednisolone, and renal bed irradiation resulted in a substantial improvement in renal function which persisted until the the patient's death from marrow failure some eight years later. The temporal association between treatments and response suggested that renal bed radiotherapy had contributed to the improvement in renal function. This case is one of only two reported cases in which chronic renal failure due to CLL has been treated with radiotherapy. It is unique in that the renal response was shown histologically. Leukaemic infiltration of the kidney is common in CLL but, characteristically, is not associated with renal impairment. An improvement in renal function has been described in two patients with acute renal failure after chemotherapy.
摘要
报告了1例B细胞慢性淋巴细胞白血病（B-CLL），因白血病浸润肾脏并发慢性肾衰竭。用苯丁酸氮芥、泼尼松龙治疗以及肾脏局部放疗后，肾功能有显著改善，这种改善一直持续到约8年后患者因骨髓衰竭死亡。治疗与反应之间的时间关联提示肾脏局部放疗有助于肾功能改善。该病例是仅有的两例报告中，用放疗治疗CLL所致慢性肾衰竭的病例之一。其独特之处在于肾脏反应有组织学表现。白血病浸润肾脏在CLL中很常见，但典型的是不伴有肾功能损害。已有两名急性肾衰竭患者化疗后肾功能改善的报道。
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