Reactions 1680, p43 - 2 Dec 2017 Obstructive uropathy, unilateral hydronephrosis and renal damage: case report A 14-year-old boy developed obstructive uropathy, unilateral hydronephrosis and renal damage following chemotherapeutic treatment with daunorubicin, etoposide [vepezide], doxorubicin [adriamycin], prednisolone, vincristine, tioguanine, cytarabine and cyclophosphamide [dosages, routes and time to reactions onset not stated]. The boy presented for a periodical health test. During the ultrasonography, right hydronephrosis was revealed unexpectedly (he had no complaints). When he was 8 years old, he was diagnosed with acute myeloblastic leukaemia (AML). He was then treated with daunorubicin, etoposide, doxorubicin, prednisolone, vincristine, tioguanine, cytarabine and cyclophosphamide chemotherapy (AML-BFM-93 protocol). No renal lesions were found before and after chemotherapy. Previous yearly ultrasound examinations had showed no alteration of the kidneys. He was admitted for further treatment and tests. A repeat ultrasonography revealed right hydronephrosis. Anteroposterior diameter of pelvis was 50mm. Parenchymal thinning and calyceal dilatation were observed. Intravenous urography revealed normal left kidney. The boy underwent right retroperitoneoscopic nephrectomy. The kidney had slight atrophy of the parenchyma. Histopathology showed chronic tubulointerstitial nephritis. A copious infiltration of lymphocytes, several plasmocytes, and granulocytes was seen in the stroma. Tubular obstruction with a prominent amount of small eosinophilic and periodic acid-Schiff (PAS) positive cylinders was seen. Tubular epithelium was focally detached. Peritubular fibrosis was noted around excretory tubules. He was investigated for the possibility of BK virus nephritis, but no specific histological signs were seen. Author comment: "In the pathogenesis of this severe unilateral renal damage, we suspect the exacerbation of deleterious effects of cytostatic therapy on kidneys with intermittent hydronephrosis.""Renal damage as a consequence of haematologic malignancy and cytostatic therapy is well known". Simanauskiene E, et al. Unilateral hydronephrosis and renal damage after acute leukemia. Case Reports in Medicine 2012: 968491, 2012. Available from: URL: http://doi.org/10.1155/2012/968491 - Lithuania 803284780 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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