Letter to the EditorAcute lymphoblastic leukemia presenting as non-oliguric renal failure and hypertension
Introduction
Renal involvement in acute lymphoblastic leukemia usually occurs late in the course of the disease; however, only 3–5% patients may have enlarged kidneys at presentation [1] mostly in the pediatric age group. We present an unusual case of acute lymphoblastic leukemia presenting as non-oliguric renal failure and hypertension in an adult patient along with the review of literature.
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Case report
A 22 years male presented to our hospital with history of abdominal pain, vomiting and vertigo since 2 months. On examination, he was found to be hypertensive (180/110 mm Hg) and investigations revealed deranged renal function tests (urea 44 mg/dl, creatinine 2.2 mg/dl). Complete blood count revealed: Hb 12.6 gm/dl, TLC 5.4 × 109/l, P61 L27 M8 E and Plt 189 × 109/l. Abdominal ultrasonography revealed bilateral enlarged kidneys (right kidney measuring 166 mm × 74 mm and left kidney measuring 162 mm × 78 mm)
Discussion
Renal involvement is not uncommon in acute lymphoblastic leukemia and is known to occur late in the course of the disease; however, only 3–5% patients may have enlarged kidneys at presentation [1], as in this case. Moreover, most of the cases are reported in pediatric patients [2], [3], [4], [5] and there is paucity of data in adults [6], [7], [8]. Also, renal failure is rarely a presenting symptom in patients with leukemia [9]. Renal infiltration is seen in up to 50% and 90% patients of
Acknowledgements
Authors are thankful to all our colleagues in department of haematology for their critical support.
Contributions: N.G. wrote the manuscript; S.G. provided the image and co-authored the manuscript; S.R. revised the manuscript; S.S. did the literature search and M.M., T.S., P.M. and R.S. reviewed the manuscript.
Conflict of interest: no conflict of interest existed.
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