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Nefrologia ; 33(6): 845-8, 2013 Nov 13.
Artículo en Inglés, Español | MEDLINE | ID: mdl-24241370

RESUMEN

A 37-year-old patient was transferred to Haematology from the ENT Emergency Department where he had been admitted due to tonsillitis. He displayed anaemia and leukopenia and had agranulocytosis in the study. A day later the patient had blast crisis, and was diagnosed with myeloid acute leukaemia. Due to blast crisis the patient experienced sudden back pain, with oliguria and renal function deterioration followed by anaemia, in the context of haemolysis consistent with thrombotic microangiopathy, and as such, we were consulted. We began treatment with plasmapheresis and on the following day we performed haemodialysis (we carried out a total of 12 sessions of plasmapheresis until haemolysis disappeared). Five days later there was respiratory failure, and the patient was consequently transferred to the Intensive Care Unit, where he continued treatment with plasmapheresis and haemodialysis. The patient remained anuric thereafter, requiring haemodialysis, with no sign of renal recovery. Once platelet levels normalised with haematology chemotherapy, a percutaneous renal biopsy was performed, which confirmed the diagnosis of cortical necrosis. Finally, the patient underwent renal replacement therapy by regular haemodialysis.


Asunto(s)
Crisis Blástica/complicaciones , Síndrome Hemolítico-Urémico/etiología , Necrosis de la Corteza Renal/etiología , Leucemia Promielocítica Aguda/complicaciones , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Idarrubicina/administración & dosificación , Isquemia/etiología , Riñón/irrigación sanguínea , Necrosis de la Corteza Renal/terapia , Leucemia Promielocítica Aguda/diagnóstico , Leucemia Promielocítica Aguda/tratamiento farmacológico , Leucemia Promielocítica Aguda/patología , Masculino , Plasma , Plasmaféresis , Diálisis Renal , Insuficiencia Respiratoria/etiología , Tonsilitis/complicaciones , Tretinoina/administración & dosificación
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