Renal collapse: A window into an underlying high-grade hematological malignancy – A case report

Paras Mahajan *, Suresh Kumar, Harpreet Singh, Nidhi Anand and Abhilash Patowary

Department of Internal Medicine, Maulana Azad Medical College and associated hospitals, New Delhi – 110002, India.
 
Case Report
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(03), 429-434.
Article DOI: 10.30574/wjbphs.2024.20.3.1039
Publication history: 
Received on 12 November 2024; revised on 21 December 2024; accepted on 23 December 2024
 
Abstract: 
Kidney disease is prevalent in patients with hematologic malignancies, particularly multiple myeloma (MM) and acute leukemias. These conditions can directly infiltrate the kidneys or disrupt renal function through metabolic and immunological mechanisms. Renal failure is a significant complication, often the second leading cause of mortality in MM patients. Over 50% of multiple myeloma patients experience renal impairment, commonly identified as "myeloma kidney." Occasionally, blastoid morphology of some plasma cells can lead to diagnostic confusion, necessitating the use of immunohistochemistry to distinguish plasma cell leukemia (PCL) from other types of leukemias and lymphomas. Accurate diagnosis of renal disease can also reveal underlying hematologic malignancies, as demonstrated in our case where a kidney biopsy diagnosed a high-grade malignancy, facilitating timely and correct management.
 
Keywords: 
Plasma cell leukemia; Cast nephropathy; Kidney biopsy; Blast cells; Chemotherapy
 
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