Akut Lenfoblastik Löseminin Ender İlk Başvuru Bulgusu: Bilateral Nefromegali

Year 2017, , 36 - 38, 01.01.2017

Enes Çelik Nurdan Yıldız Serçin Güven Emel Şenay İbrahim Gökçe

https://doi.org/10.5222/j.child.2017.036

Abstract

Akut lenfoblastik lösemi ALL çocukluk çağının en sık görülen kanseridir. Hastaların %8-16’sında klinik bulgu vermeyen böbrek tutulumu görülebilir, bunların çoğunda hasta lösemi tanısı aldıktan sonra böbrek tutulumu sapta- nır. Bu makalede karında şişkinlik nedeniyle başvuran, bilateral nefromegalisi olan ve tetkiklerin sonucunda pre B hücreli ALL tanısı alan 18 aylık vaka sunularak nefromega- linin ayırıcı tanısında lösemik infiltrasyonun önemi vurgu- landı

Keywords

Nefromegali, akut lenfoblastik lösemi, böbrek tutulumu, lösemik infiltrasyon

An Unusual Cause of Bilateral Nephromegaly as the Rarely Seen First Presenting Finding of Acute Lymphoblastic Leukemia

Abstract

Acute lymphoblastic leukemia ALL is the most common type of cancer in childhood. Renal involvement may occur in 8-16% of patients without clinical manifestation and is detected in the majority of these cases renal involvement is detected after the patient received diagnosis of leukemia.. In this article, we presented a 18 month-old girl presented with abdominal distension and bilateral nephromegaly who was diagnosed with pre-B cell B-cell precursor acute lymphob- lastic leukemia, and emphasized that lymphoblastic infiltra- tion should be considered in the differential diagnosis of a patient presenting with unexplained nephromegaly

Keywords

Nephromegaly, acute lymphoblastic leukemia, renal involvement, lymphoblastic infiltration

References

• Erdem E, kayıran p, ozcelik G, ozel A, Yildiz Yildirmak z. Rare presentation of pediatric acute lymphoblastic leuke- mia: nephromegaly at time of diagnosis. Indian J Hematol Blood Transfus 2011;27:43-5. https://doi.org/10.1007/s12288-010-0052-0
• Lanzkowsky p. Manual of Pediatric Hematology and Oncology. 5th ed. New York: Elsevier, 2011; 518-66. https://doi.org/10.1016/B978-0-12-375154-6.00017-3
• olgar S, Cetin M, Gürgey A, Tuncer M, Gümrük F, oner AF, et al. Akut lenfoblastik lösemili hastalarda hücre morfo- lojisi ve böbrek etkilenmesi. 29. Ulusal Hematoloji Kongresi 25-28 Kasım, Kemer/Antalya, 2002;19:1.
• Hann ıM, Lees pd, palmer Mk, Gupta S, Morris-Jones pH. Renal size as a prognostic factor in childhood acute lymphoblastic leukemia. Cancer 1981;48:207-9. https://doi.org/10.1002/1097-0142(19810701)48: 13.0.CO;2-0
• doğan M, Bay A, Bora A, Açıkgöz M, öner AF. Massively enlarged kidneys due to leukemic infiltration in a child. European Journal of General Medicine 2010; 114-7.
• pradeep R, Madhumathi dS, Lakshmidevi v, premalata CS, Appaji L, patil SA, Swapnil B. Bilateral nephromegaly simula- ting wilms tumor: a rare initial manifestation of acute lymphob- lastic leukemia. J Pediatr Hematol Oncol 2008;30:471-3. https://doi.org/10.1097/MPH.0b013e318168e7b3
• Saha A, dandekar S, Milla S, Roman E, Bhatla T. Bilateral parotid gland enlargement and palpable nephromegaly in infant acute lymphoblastic leukemia: case report and review of the literature. J Pediatr Hematol Oncol 2014;36:246-8. https://doi.org/10.1097/MPH.0000000000000076
• Aksu Uzunhan T, karakaş z. Çocukluk çağı akut Lenfoblastik Lösemisi. Çocuk Dergisi 2012;12:6-15. https://doi.org/10.5222/j.child.2012.006
• Boueva A, Bouvier R. Precursor B-cell lymphoblastic leuke- mia as a cause of a bilateral nephromegaly. Pediatr Nephrol 2005;20:679-82. https://doi.org/10.1007/s00467-004-1740-5
• Hilmes MA, dillman JR, Mody RJ, Strouse pJ. Pediatric renal leukemia: spectrum of CT imaging findings. Pediatr Radiol 2008;38:424-30. https://doi.org/10.1007/s00247-007-0741-5
• Aguayo p, Fraser Jd, St peter Sd, Spilde T, Gatti JM, Snyder CL, ostlie dJ. Massive bilateral nephromegaly in acute lymphoblastic leukemia: a case report. Eur J Pediatr Surg 2009;19:332-4. https://doi.org/10.1055/s-2008-1039191
• Araki T. Leukemic Involvement of the Kidney in Children: CT Features. J Comput Assist Tomogr 1982;6:781-4. https://doi.org/10.1097/00004728-198208000-00022
• Spiegel A, kollet o, peled A, Abel L, Nagler A, Bielorai B, et al. Unique SDF-1-induced activation of human precursor-B ALL cells as a result of altered CXCR4 expression and signa- ling. Blood 2004;103: 2900-7. https://doi.org/10.1182/blood-2003-06-1891
• Stefanidakis M, karjalainen k, Jaalouk dE, Gahmberg CG, o’Brien S, pasqualini R, et al. Role of leukemia cell inva- dosome in extramedullary infiltration. Blood 2009;114:3008-17. https://doi.org/10.1182/blood-2008-04-148643