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Indian Journal of Pediatrics
Published in: Indian Journal of Pediatrics 7/2019

01-07-2019 | Acute Lymphoblastic Leukemia | Scientific Letter

Acute Lymphoblastic Leukemia Occurring Five Years After Onset of Steroid Resistant Nephrotic Syndrome

Authors: G. R. Jaikumar, Sriram Krishnamurthy, C. G. Delhi Kumar, S. V. Dhurva Sandeep, Biswajit Dubashi, Debdatta Basu

Published in: Indian Journal of Pediatrics | Issue 7/2019

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Excerpt

To the Editor: An eight-year-old boy was being treated for idiopathic steroid resistant nephrotic syndrome (NS) since 3 y of age. The renal biopsy showed Minimal Change Disease. He was treated with intravenous cyclophosphamide pulses (cumulative dose 3 g/m2, equivalent to 160 mg/kg) without remission; and thereafter, cyclosporin for two years, being in partial remission. Later, due to cyclosporin toxicity (severe gum hypertrophy and hirsutism, although serum creatinine and magnesium continued to be normal), intravenous rituximab was administered followed by mycophenolate mofetil (MMF) and prednisolone. He showed marked reduction in proteinuria, with no edema. The complete blood counts (CBC) and serum creatinine were monitored 3-monthly and remained normal. …
Literature
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Audard V, Larousserie F, Grimbert P, et al. Minimal change nephrotic syndrome and classical Hodgkin's lymphoma: report of 21 cases and review of the literature. Kidney Int. 2006;69:2251–60.CrossRefPubMed
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Bhatia M, Kher K, Minniti CP. Acute lymphoblastic leukemia in a child with nephrotic syndrome. Pediatr Nephrol. 2004;19:1290–3.CrossRefPubMed
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Müller W, Brandis M. Acute leukemia after cytotoxic treatment for non-malignant disease in childhood. A case report and review of the literature. Eur J Pediatr. 1981;136:105–8.CrossRefPubMed
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Fiser RT, Arnold WC, Charlton RK, Steele RW, Childress SH, Shirkey B. T-lymphocyte subsets in nephrotic syndrome. Kidney Int. 1991;40:913–6.CrossRefPubMed
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Berns JS, Gaudio KM, Krassner LS, et al. Steroid-responsive nephrotic syndrome of childhood: long-term study of clinical course, histology, efficacy of cyclophosphamide therapy, and effects on growth. Am J Kidney Dis. 1987;9:108–14.CrossRefPubMed
Metadata
Title
Acute Lymphoblastic Leukemia Occurring Five Years After Onset of Steroid Resistant Nephrotic Syndrome
Authors
G. R. Jaikumar
Sriram Krishnamurthy
C. G. Delhi Kumar
S. V. Dhurva Sandeep
Biswajit Dubashi
Debdatta Basu
Publication date
01-07-2019
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 7/2019
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-019-02954-z

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