A rare cause of acute kidney injury with chronic myelomonocytic leukemia
| Autor: | Joel Branch, Marina Asano, Yuki Naruse, Iori Kojima, Hideaki Shimizu, Hiroshi Kitamura, Kyogo Kawada, Hanako Hase |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Nephrology
medicine.medical_specialty Pathology 030232 urology & nephrology Chronic myelomonocytic leukemia Case Report 030204 cardiovascular system & hematology urologic and male genital diseases Peripheral blood mononuclear cell 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Leukocytosis Kidney business.industry urogenital system Acute kidney injury General Medicine medicine.disease female genital diseases and pregnancy complications medicine.anatomical_structure medicine.symptom business Infiltration (medical) Immunostaining |
| Zdroj: | CEN Case Rep |
| Popis: | An 80-year-old man with myelodysplastic syndrome developed acute kidney injury (AKI) and peripheral blood monocyte-dominant leukocytosis. Glomerular disease was suspected from urinalysis, which showed proteinuria and microscopic hematuria with red cell casts. Eventually, he died of respiratory failure, after which a postmortem was performed. In the glomeruli, the extracapillary space was filled with numerous mononuclear cells and erythrocytes. At first interpretation, the glomerular findings appeared to represent cellular crescents. However, immunostaining revealed that the extracapillary mononuclear cells were in fact leukemic cells. Furthermore, tubular injury due to marked accumulation of lysozyme was also recognized together with infiltration of leukemic cells in the interstitium. The diagnosis of kidney infiltration by chronic myelomonocytic leukemia (CMML) and lysozyme-induced tubular injury was eventually made. Our case is the first report showing extracapillary infiltration of leukemic cells by immunostaining. In addition, lysozyme-induced tubular injury is a forgotten cause of kidney injury in patients with CMML. This case teaches us the rare and forgotten causes of AKI with CMML. |
| Databáze: | OpenAIRE |
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