Abstract:

Objective To explore the causes of nephrotic syndrome in patients with chronic myeloid leukemia (CML) and methods for differential diagnosis. Methods We retrospectively analyzed the clinical data of one patient with CML complicated by membranoproliferative glomerulonephritis (MPGN) and reviewed the relevant literature. Results The patient was a 75-year-old man with a 6-year history of CML, bilateral lower-limb edema for 4 years, and elevated serum creatinine for 2 weeks prior to admission. On admission, renal function tests showed serum creatinine 150.4 μmol/L and 24-hour urine protein 1.35 g/24 h. Percutaneous renal biopsy demonstrated MPGN with changes consistent with hypertensive renal damage. After reduction of imatinib mesylate dose combined with antihypertensive and antiproteinuric therapy, the patient's lower-limb edema improved and proteinuria decreased markedly; overall clinical condition improved. Conclusion In CML patients who develop renal impairment, a careful review of past medical history and medication exposure is essential, and percutaneous renal biopsy should be performed to distinguish between renal involvement by CML and tyrosine kinase inhibitor-related nephropathy.

Key words: glomerulonephritis, membranoproliferative, leukemia, myeloid, platelet-derived growth factor, tyrosine kinase inhibitors