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KMID : 0366219810160020115
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Korean Journal of Hematology
1981 Volume.16 No. 2 p.115 ~ p.123
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A Case of Nephrotic Syndrome in Chronic Myelocytic Leukemia
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고윤웅/Yun Woong Ko
백승정/허균/이선주/정석호/김진/최인준/Seung Jung Bahk/Kyoon Huh/Sun Ju Lee/Suk Ho Chung/Jin Kim/In Joon Choi
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Abstract
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The nephrotic syndrome complicating malignancy in the absence of renal vein
thrombosis, amyloidosis or neoplastic infiltration of the kidney is an unusual occurrence.
Presented here, a case of chronic myelocytic leukemia presenting with the nephrotic
syndrome. With the best of our knowledge, this might be the first case report in the
literature.
A 54 year old female patient was admitted because of general malaise and generalized
edema. At that time, peripheral blood and bone marrow findings revealed chronic
myelocytic leukemia, which had Positive Philadelphia chromosome, and other labaratory
findings were compatable with nephrotic syndrome certainly.
Renal biopsy revealed membranous glomerulonephritis by electron microscopy. Ig G
and C3 deposition were present in the glomerular basement membrane by
immunofluorescence. After chemotherapy with cytosine arabinoside, 6-thioguanine and
myleran for chronic myelocytic leukemia, the nephrotic syndrome was almost completely
improved. It is postulated that deposition of chronic myelocytic leukemia-associated
immune complexes on the glomerular basement membrane was responsible for the
development of the nephrotic syndrome in this patient.
Six months later, she revealed relapsed nephrotic syndrome followed by florid pictures
of chronic myelocytic leukemia with an interval of 3 weeks. This episode supported that
overt chronic myelocytic leukemia may be heralded by nephrotic syndrome.
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