BACKGROUND: All-trans retinoic acid (ATRA) is a vitamin A derivative that is used in combination with chemotherapy to treat acute promyelocytic leukemia (APL). A serious complication of ATRA is retinoic acid syndrome (RAS), which is characterized by an inflammatory reaction with capillary leakage and myeloid cell tissue invasion that presents with cardiopulmonary symptoms and occasionally acute kidney injury. CASE-DIAGNOSIS/TREATMENT: We report the case of a 3-year-old child with APL who developed transient nephrotic-range proteinuria (max urine protein:creatinine ratio 8.6) during two episodes of RAS while on ATRA therapy. ATRA was temporarily discontinued and the patient was treated with a 3-day course of dexamethasone during each episode. He maintained normal renal function throughout and the proteinuria completely resolved. CONCLUSIONS: This is the first reported occurrence of nephrotic-range proteinuria in a child treated with ATRA. Nephrologists should be aware that RAS is a serious complication of ATRA that may lead to proteinuria.
BACKGROUND:All-trans retinoic acid (ATRA) is a vitamin A derivative that is used in combination with chemotherapy to treat acute promyelocytic leukemia (APL). A serious complication of ATRA is retinoic acid syndrome (RAS), which is characterized by an inflammatory reaction with capillary leakage and myeloid cell tissue invasion that presents with cardiopulmonary symptoms and occasionally acute kidney injury. CASE-DIAGNOSIS/TREATMENT: We report the case of a 3-year-old child with APL who developed transient nephrotic-range proteinuria (max urine protein:creatinine ratio 8.6) during two episodes of RAS while on ATRA therapy. ATRA was temporarily discontinued and the patient was treated with a 3-day course of dexamethasone during each episode. He maintained normal renal function throughout and the proteinuria completely resolved. CONCLUSIONS: This is the first reported occurrence of nephrotic-range proteinuria in a child treated with ATRA. Nephrologists should be aware that RAS is a serious complication of ATRA that may lead to proteinuria.
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Authors: S Castaigne; P Lefebvre; C Chomienne; E Suc; F Rigal-Huguet; C Gardin; A Delmer; E Archimbaud; H Tilly; M Janvier Journal: Blood Date: 1993-12-15 Impact factor: 22.113
Authors: S De Botton; H Dombret; M Sanz; J S Miguel; D Caillot; R Zittoun; M Gardembas; A Stamatoulas; E Condé; A Guerci; C Gardin; K Geiser; D C Makhoul; O Reman; J de la Serna; F Lefrere; C Chomienne; C Chastang; L Degos; P Fenaux Journal: Blood Date: 1998-10-15 Impact factor: 22.113