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Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia

INTRODUCTION: Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL). CASE REPORT: 18-month-old female toddler presented with fever and progressive abdominal distension of 4–6 weeks duration. Imaging revea...

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Autores principales: Vijayasekharan, Kalasekhar, Bhat K, Vasudeva, Venkatagiri, Archana M, Godkhindi, Vishwapriya M, Laxminarayana, Sindhura Lakshmi Koulmane, Belurkar, Sushma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170146/
https://www.ncbi.nlm.nih.gov/pubmed/34113542
http://dx.doi.org/10.1016/j.lrr.2021.100246
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author Vijayasekharan, Kalasekhar
Bhat K, Vasudeva
Venkatagiri, Archana M
Godkhindi, Vishwapriya M
Laxminarayana, Sindhura Lakshmi Koulmane
Belurkar, Sushma
author_facet Vijayasekharan, Kalasekhar
Bhat K, Vasudeva
Venkatagiri, Archana M
Godkhindi, Vishwapriya M
Laxminarayana, Sindhura Lakshmi Koulmane
Belurkar, Sushma
author_sort Vijayasekharan, Kalasekhar
collection PubMed
description INTRODUCTION: Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL). CASE REPORT: 18-month-old female toddler presented with fever and progressive abdominal distension of 4–6 weeks duration. Imaging revealed bilateral massively enlarged kidneys with normal excretion. Peripheral blood counts and smear examination was unremarkable and immunophenotypic evaluation of marrow was consistent with T-ALL. Chest imaging was unremarkable. She was started on modified Indian Childhood Collaborative Leukemia Group (ICiCLe) ALL protocol. Even with the best anti-tumor lysis syndrome (TLS) prophylaxis the child required two sessions of hemodialysis. An end-induction morphological remission & end-consolidation negative minimal residual disease (MRD) could be achieved. CONCLUSION: Bilateral massive nephromegaly is an extremely rare presentation of T-ALL. This case emphasizes the unusual presentation, need for prompt remediation of TLS, and most importantly the use of early intensification with four drug anthracycline & dexamethasone-based therapy for the treatment of T-ALL in children.
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spelling pubmed-81701462021-06-09 Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia Vijayasekharan, Kalasekhar Bhat K, Vasudeva Venkatagiri, Archana M Godkhindi, Vishwapriya M Laxminarayana, Sindhura Lakshmi Koulmane Belurkar, Sushma Leuk Res Rep Article INTRODUCTION: Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL). CASE REPORT: 18-month-old female toddler presented with fever and progressive abdominal distension of 4–6 weeks duration. Imaging revealed bilateral massively enlarged kidneys with normal excretion. Peripheral blood counts and smear examination was unremarkable and immunophenotypic evaluation of marrow was consistent with T-ALL. Chest imaging was unremarkable. She was started on modified Indian Childhood Collaborative Leukemia Group (ICiCLe) ALL protocol. Even with the best anti-tumor lysis syndrome (TLS) prophylaxis the child required two sessions of hemodialysis. An end-induction morphological remission & end-consolidation negative minimal residual disease (MRD) could be achieved. CONCLUSION: Bilateral massive nephromegaly is an extremely rare presentation of T-ALL. This case emphasizes the unusual presentation, need for prompt remediation of TLS, and most importantly the use of early intensification with four drug anthracycline & dexamethasone-based therapy for the treatment of T-ALL in children. Elsevier 2021-05-19 /pmc/articles/PMC8170146/ /pubmed/34113542 http://dx.doi.org/10.1016/j.lrr.2021.100246 Text en © 2021 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Vijayasekharan, Kalasekhar
Bhat K, Vasudeva
Venkatagiri, Archana M
Godkhindi, Vishwapriya M
Laxminarayana, Sindhura Lakshmi Koulmane
Belurkar, Sushma
Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title_full Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title_fullStr Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title_full_unstemmed Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title_short Bilateral massive nephromegaly–A rare presentation of t-cell acute lymphoblastic leukemia
title_sort bilateral massive nephromegaly–a rare presentation of t-cell acute lymphoblastic leukemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170146/
https://www.ncbi.nlm.nih.gov/pubmed/34113542
http://dx.doi.org/10.1016/j.lrr.2021.100246
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