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Nephrol Dial Transplant (2003) 18: 1214-1216
© 2003 European Renal Association-European Dialysis and Transplant Association

Interesting Case

Symptomatic lactic acidosis due to relapse of T-cell acute lymphoblastic leukaemia in the kidney

Bart De Keulenaer1,5,, Steven Van Outryve1, Adelard De Backer2, Lode Van Overbeke1, Ronny Daelemans3, Erik Van Marck4, Dirk Schepens3 and Dianne Stephens5

1 Department of Intensive Care, 2 Department of Radiology, 3 Department of Nephrology-Hypertension, Stuivenberg General Hospital, Antwerp, Belgium, 4 Department of Anatomopathology, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium and 5 Department of Intensive Care, Royal Darwin Hospital, Darwin, Australia

Keywords: chemotherapy; lactic acidosis; neoplasia; T-cell acute lymphoblastic leukaemia

The first 150 words of the full text of this article appear below.

Introduction

Lactic acidosis is a common cause of metabolic acidosis in intensive care patients. Two different types of lactic acidosis exist. Type A lactic acidosis is due to widespread tissue hypoperfusion or hypoxaemia. Type B lactic acidosis can occur in haematological malignancies, such as leukaemia or lymphoma. We describe a patient, previously successfully treated for a T-cell acute lymphoblastic leukaemia (T-ALL), presenting with a symptomatic type B lactic acidosis due to a relapse with isolated renal localization.

Case

A 29-year-old Caucasian male was admitted to the hospital because of a painful cutaneous lesion on the skull with, on physical examination, hepatomegaly and splenomegaly. Blood examination revealed moderate leucocytosis (24 000/mm3) with 50% blast cells and severe thrombocytopaenia (10 000/mm3). Liver function tests were abnormal: aspartate aminotransferase 90 U/l (normal values 17–59 U/l), alanine aminotransferase 158 U/l (21–72 U/l) and lactate dehydrogenase 5573 U/l (316–618 U/l). A T-ALL, with involvement of . . . [Full Text of this Article]

Discussion


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