muramidase and Leukemia--Myelomonocytic--Chronic

Lysozyme-induced nephropathy is a rare and unknown complication of chronic myelomonocytic leukemia with overproduction of lysozyme by tumoral cells leading to proximal tubular cells injuries. The present case reports a lysozyme nephropathy secondary to chronic myelomonocytic leukemia.. We reported a case of a 82-years-old woman who presented an acute renal failure in a context of diarrhea and vomiting. Her background was characterized by untreated chronic myelomonocytic leukemia and high blood pressure. Despite rehydration, renal function deteriorated. Renal biopsy revealed a tubulo-interstitial lysozyme-induced nephropathy with a vacuolization of the tubular epithelium by eosinophilic droplets stained by anti-lysozyme antibody, without tumoral infiltration of the renal parenchyma.. Lysozyme-induced nephropathy is a rare disease which can be suspected biologically and needs histologic confirmation. Other causes of renal failure secondary to chronic myelomonocytic leukemia have to be eliminated first in these patients. The treatment is symptomatic and is associated with treatments of the underlying hematologic pathology.

Topics: Acute Kidney Injury; Aged, 80 and over; Female; Humans; Kidney; Leukemia, Myelomonocytic, Chronic; Muramidase

Topics: Aged; Biopsy; Female; Humans; Kidney Diseases; Kidney Tubules; Leukemia, Myelomonocytic, Chronic; Lysosomes; Microscopy, Electron; Muramidase

Kidney failure is common in haematologic malignancies. However, the nephrotoxic effect of lysozyme is seldom recognized. We present a 78-year-old male with chronic myelomonocytic leukaemia who developed progressive kidney failure due to increased production of lysozyme.

Topics: Aged; Disease Progression; Humans; Leukemia, Myelomonocytic, Chronic; Liver; Male; Muramidase; Renal Insufficiency

Topics: B7-2 Antigen; Down-Regulation; Drug Evaluation; Drug Screening Assays, Antitumor; Female; Humans; Interleukin-10; Leukemia, Myelomonocytic, Chronic; Male; Monocytes; Muramidase; Neoplasm Proteins; Pilot Projects; Recombinant Proteins; Skin; Tumor Cells, Cultured

Topics: Aged; Biopsy; Diagnosis, Differential; Humans; Kidney; Leukemia, Myelomonocytic, Chronic; Male; Muramidase; Renal Insufficiency

We report two cases of extramedullary myeloid cell tumor that arose in patients with chronic myelomonocytic leukemia. In both cases, the tumors were difficult to recognize histologically because the neoplasms lacked cytological evidence of granulocyte maturation, such as cytoplasmic granulation or eosinophilic myelocytes, and the Leder stains for chloroacetate esterase were negative. Immunohistochemical studies were necessary to establish the correct diagnosis. The neoplastic cells in both tumors expressed myeloperoxidase, lysozyme, and CD43 and were negative for B-cell, T-cell, and other nonhematopoietic antigens tested. We report these cases to emphasize that extramedullary myeloid cell tumors may rarely precede transformation to acute myeloid leukemia in patients with chronic myelomonocytic leukemia. Extramedullary myeloid cell tumors of monocytic lineage may be difficult to recognize in routine and Leder-stained sections, and immunohistochemical studies may be essential for establishing the diagnosis.

Topics: Aged; Antibodies, Monoclonal; Antigens, CD; Humans; Immunoenzyme Techniques; Immunophenotyping; Leukemia, Myeloid; Leukemia, Myelomonocytic, Chronic; Leukosialin; Lymph Nodes; Male; Middle Aged; Muramidase; Peroxidase; Sialoglycoproteins; Skin Neoplasms; Tumor Suppressor Protein p53

Topics: Blast Crisis; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myelomonocytic, Chronic; Male; Middle Aged; Muramidase