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

Kalasekhar Vijayasekharan, Vasudeva Bhat K, Archana M. Venkatagiri, Vishwapriya M. Godkhindi, Sindhura Lakshmi Koulmane Laxminarayana, Sushma Belurkar

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number100246
JournalLeukemia Research Reports
Volume15
DOIs
Publication statusPublished - 01-2021

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology

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