Abstract
A 5-year-old boy was admitted for anemia, thrombocytopenia, and azotemia. Bone marrow examination demonstrated only erythroid hyperplasia, and he was diagnosed with an atypical form of hemolytic uremic syndrome (HUS). He was treated with daily prednisolone, and hematological profiles and renal function normalized 1 month later. However, heavy proteinuria persisted, and renal biopsy findings were consistent with HUS. Four months later, pancytopenia developed with recurrence of azotemia, and a second bone marrow examination revealed acute lymphoblastic leukemia (ALL). The remission of proteinuria with no recurrences of HUS after antileukemic treatment suggests that the HUS was associated with the ALL.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gordon LI, Kwaan HC (1999) Thrombotic microangiopathy manifesting as thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in the cancer patient. Semin Thromb Hemost 25:217–221
Krauss S, Sonoda T, Solomon A (1979) Treatment of advanced gastrointestinal cancer with 5-fluorouracil and mitomycin C. Cancer 43:1598–1603
Cavagnaro F, Barriga F (2000) Hemolytic uremic syndrome in a child with leukemia and cytomegalovirus infection. Pediatr Nephrol 14:1118–1120
Kanchi H, Webb NJ, Eden OB (2000) Hemolytic uremic syndrome secondary to the treatment of acute lymphoblastic leukemia. J Pediatr Hematol Oncol 22:483–484
Honda K, Ando A, Endo M, Shimizu K, Higashihara M, Nitta K, Nihei H (1997) Thrombotic microangiopathy associated with alpha-interferon therapy for chronic myelocytic leukemia. Am J Kidney Dis 30:123–130
Stratta P, Canavese C, Dogliani M, Thea A, Degani G, Mairone L, Vercellone A (1993) Hemolytic-uremic syndrome during recombinant alpha-interferon treatment for hairy cell leukemia. Ren Fail 15:559–561
Salcedo JR, Fusner J (1986) Hemolytic uremic syndrome followed by acute lymphocytic leukemia. Int J Pediatr Nephrol 7:169–172
Martini G, Dall'Amico R, Murer L, Montini G, D'Avino A, Zacchello G (2000) Hemolytic-uremic syndrome as a presenting form of acute lymphocytic leukemia. Ann Hematol 79:452–454
Neild GH (1994) Haemolytic uremic syndrome in practice. Lancet 343:398–401
Leone G, Sica S, De Stefano V, Teofili L, Larocca LM, D'Onofrio G, Zollino M (1992) Acute onset of juvenile myelodysplastic syndrome mimicking thrombotic thrombocytopenic purpura and rapidly evolving in overt myeloid leukemia. Am J Hematol 41:64–70
Nagai K, Sugiyama Y, Hosaka T, Takaya H (1973) Histopathological studies on thrombotic microangiopathy with special references to three cases associated with acute promyelocytic leukemia. Acta Pathol Jpn 23:59–73
Okumura H, Nakamura S, Ohtake H, Yoshida T, Kobayashi K, Okabe Y, Matano S, Kyohda K, Matsuda T (1993) Hemolytic uremic syndrome developing during remission of acute myelomonocytic leukemia. Am J Hematol 44:66–67
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hahn, H., Ha, I.S., Choi, H.S. et al. Acute leukemia: an association with atypical hemolytic uremic syndrome. Pediatr Nephrol 18, 703–705 (2003). https://doi.org/10.1007/s00467-003-1119-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-003-1119-z