Renal infiltration in a child with acute leukemia complicate
Renal infiltration in children with acute leukemia has been reported previously; however, it has rarely been described in association with atypical hemolytic uremic syndrome (aHUS). Published in the Indian Journal of Nephrology, the authors present a case of 9-year-old boy who developed life-threatening aHUS in the 1st week of Burkitt leukemia/lymphoma diagnosis with renal infiltration.

Complete resolution of aHUS was achieved after therapeutic plasma exchange. This is an uncommon complication of Burkitt leukemia/lymphoma in a pediatric case.

A 9-year-old boy presented with oliguria, hypertension, and periorbital edema. He was diagnosed with precursor type t(8;14)(q24;q32)-positive Burkitt leukemia/lymphoma with central nervous system involvement and tumor lysis syndrome (TLS).

A complete blood count showed hemoglobin (Hb) concentration 8.3 g/L and platelet count 43 × 109/L. Biochemical investigations revealed elevated uric acid (9 mg/dl) and lactate dehydrogenase (LDH; 2400 IU/L). The patient's electrolyte imbalance resolved, but his urine output remained inadequate despite effective hydration and hemodialysis for TLS.

Radiological imaging and urinalysis suggested renal infiltration secondary to acute leukemia. Macroscopically, the patient's urine resembled lipemic plasma and microscopic examination revealed abundant blast cells.

Continue reading here: