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Year : 2012  |  Volume : 22  |  Issue : 3  |  Page : 217-220

Rapidly progressive renal failure due to chronic lymphocytic leukemia - Response to chlorambucil

1 Department of Nephrology, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Wales, United Kingdom
2 Department of Haematology, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Wales, United Kingdom

Correspondence Address:
N A Junglee
3rd Floor, Hebog Day Room, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, LL57 2PW, Wales
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-4065.98766

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Chronic lymphocytic leukemia tends to follow an indolent course and despite infiltration of leukemic cells in numerous organs, resultant target organ damage is uncommon. We present a case of an 83-year-old Caucasian lady who presented with rapidly worsening renal impairment over a several month period with a serum creatinine peak of 2.82 mg/dl. Despite numerous investigations an immediate cause was not apparent. A renal biopsy was therefore conducted which revealed dense infiltration of the interstitium with small lymphocytic lymphoma. Given her age and frailty she was treated with single alkylating agent chemotherapy (chlorambucil). This resulted in a marked decrease in lymphocyte count and resolution of renal impairment close to her previous baseline level. To our knowledge, this is the first case in the literature to demonstrate a marked resolution in renal impairment with chlorambucil alone. We also highlight the value of renal biopsy in identifying a rare cause of renal impairment.


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Indian Journal of Nephrology
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Online since 20th Sept '07