Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 14, 2006; 12(14): 2301-2304
Published online Apr 14, 2006. doi: 10.3748/wjg.v12.i14.2301
A rare case of enteropathy-associated T-cell lymphoma presenting as acute renal failure
Milena Bakrac, Branka Bonaci, Miodrag Krstic, Sanja Simic, Milica Colovic
Milena Bakrac, Milica Colovic, Institute of Hematology, Clinical Center of Serbia, Serbia
Branka Bonaci, Institute of Allergology and Immunology, Clinical Center of Serbia, Serbia
Miodrag Krstic, Institute of Gastroenterology, Clinical Center of Serbia, Serbia
Sanja Simic, Institute of Nephrology, Clinical Center of Serbia, Serbia
Correspondence to: Milena Bakrac, MD, PhD, Institute of Hematology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia donmil@eunet.yu
Telephone: +381-11-3065112 Fax: +381-11-3065112
Received: August 5, 2005
Revised: September 1, 2005
Accepted: October 26, 2005
Published online: April 14, 2006
Abstract

Enteropathy-associated T-cell lymphoma (EATCL) is a high grade, pleomorphic peripheral T-cell lymphoma usually with cytotoxic phenotypes. We describe a first case of patient with EATCL that is remarkable for its fulminant course and invasion of both kidneys manifested as acute renal failure. The patient was a 23 year old woman with a long history of celiac disease. She was presented with acute renal failure and enlarged mononuclear infiltrated kidneys. Diagnosis of tubuloi-nterstitial nephritis and polyserositis was confirmed with consecutive pulse doses of steroid therapy. After reco-very, she had disseminated disease two months later. Magnetic resonance imaging showed thickened intestine wall, extremely augmented kidneys, enlarged intra-abdominal lymph nodes with extra-luminal compression of common bile duct. Laparotomy with mesenterial adipous tissue and lymph glands biopsy was done. Consecutive pathophysiological and immunohistochemical analyses confirmed the diagnosis of EATCL: CD45RO+, CD43+, CD3+. The revision of renal pathophysiology sub-stantiated the diagnosis. The patient received chemotherapy, but unfortunately she died manifesting signs of pulmonary embolism caused by tumor cells.

Keywords: EATCL, Acute renal failure, Celiac disease, Anti-endomisial antibodies