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Case Reports
. 2018 Feb 1;11(1):63-67.
doi: 10.1159/000486364. eCollection 2018 Jan-Apr.

Acute Lymphoblastic Leukemia Presenting as Fanconi Syndrome

Tatsunori Yoshida  1 , Hiroshi Tsujimoto  1 , Takayuki Ichikawa  1 , Shinji Kounami  1 , Hiroyuki Suzuki  1
Affiliations
Case Reports

Acute Lymphoblastic Leukemia Presenting as Fanconi Syndrome

Tatsunori Yoshida et al. Case Rep Oncol. .

Abstract

Acute lymphoblastic leukemia (ALL) presenting as Fanconi syndrome (FS) is extremely rare. Here, we report a case of ALL presenting as bilateral nephromegaly following FS. A 2-year-old girl was unexpectedly diagnosed with bilateral nephromegaly. After 2 weeks, she developed general fatigue, thirst, and polyuria. Laboratory examinations revealed renal tubular acidosis, hypokalemia, hypophosphatemia, and aminoaciduria, and FS was diagnosed. Replacement of bicarbonate and potassium did not improve her condition. Two weeks after the onset of FS, leukemic cells appeared on a peripheral blood smear, and the patient was diagnosed with precursor B-cell ALL presenting as nephromegaly and FS. Chemotherapy brought about a prompt resolution of acidosis and electrolyte abnormalities, without renal dysfunction. The patient remains well 4 years after the onset of the disease. Although extremely rare, FS should be recognized as one of the emerging renal complications of ALL.

Keywords: Acute lymphoblastic leukemia; Fanconi syndrome; Nephromegaly; Renal tubular acidosis.

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Figures

Fig. 1.
Fig. 1.
T2-weighted magnetic resonance imaging of the abdomen showing smooth bilateral nephromegaly with loss of corticomedullary differentiation.
See this image and copyright information in PMC

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