Acute Renal Failure: A Rare Initial Presentation of Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia has several presentations associated with bone marrow and extramedullary involvement. The unusual presentation may be due to the infiltration of leukemic cells in any organ. An ۱۱-year-old girl presented with fever and vomiting, since one day before admission after starfish biting during swimming. Her vital signs were: blood pressure ۱۵۰/۱۰۰ mmHg, pulse ۹۸ beats per minute, respiration ۱۸ breathes per minute, and temperature ۳۷.۲ °C (۹۹ F). Laboratory work-up showed blood urea nitrogen ۳۸ mg/dl and creatinine ۲.۸ mg/dl. In peripheral blood smear, few atypical cells, mild anemia (Hb: ۹.۲ g/dl), and mild thrombocytopenia (Platelet: ۱۰۹,۰۰۰/μL) were detected. Bone marrow aspiration and immunophenotyping were in favor of acute precursor B cell type lymphoblastic leukemia. The patient had a favorable response to treatment after initiating high-risk chemotherapy. Therefore, acute renal failure can be a rare initial presentation of acute lymphoblastic leukemia, and azotemia will improve with an early chemotherapy treatment.

کلیدواژه ها:

Renal Failure ، Acute Lymphocytic Leukemia ، Precursor B-Cell Lymphoblastic Leukemia ، Azotemia