Skip to main content
Erschienen in: Pediatric Nephrology 7/2011

01.07.2011 | Brief Report

Karyomegalic-like nephropathy, Ewing’s sarcoma and ifosfamide therapy

verfasst von: Tom McCulloch, Andrew Prayle, Andy Lunn, Alan R. Watson

Erschienen in: Pediatric Nephrology | Ausgabe 7/2011

Einloggen, um Zugang zu erhalten

Abstract

Karyomegalic interstitial nephropathy has been reported as a rare interstitial nephritis in adult patients. Histology shows atypical epithelial cells and large abnormal hyperchromatic nuclei with irregular outlines. We report 3 adolescent patients who all recovered from their initial treatment for Ewing’s sarcoma but developed a tubulopathy attributed to ifosfamide therapy. Renal impairment resulted in biopsy, which showed features of karyomegalic nephropathy in all 3. One patient has progressed to haemodialysis. Recognition of the pathology may be important in similar patients. It is surmised that the unusual histological findings in these patients stem from a common pathogenesis which may be related to chemotherapeutic agent related nuclear damage. At present there is no specific treatment to prevent progressive renal impairment.
Literatur
1.
Zurück zum Zitat Burry AF (1974) Extreme dysplasia in renal epithelium of a young woman dying from hepatocarcinoma. J Pathol 113:147–150CrossRef Burry AF (1974) Extreme dysplasia in renal epithelium of a young woman dying from hepatocarcinoma. J Pathol 113:147–150CrossRef
2.
Zurück zum Zitat Mihatsch MJ, Gudat F, Zollinger HU, Heierli C, Tholen H, Reutter FW (1979) Systemic karyomegaly associated with chronic interstitial nephritis. A new disease entity? Clin Nephrol 12:54–62PubMed Mihatsch MJ, Gudat F, Zollinger HU, Heierli C, Tholen H, Reutter FW (1979) Systemic karyomegaly associated with chronic interstitial nephritis. A new disease entity? Clin Nephrol 12:54–62PubMed
3.
Zurück zum Zitat Bhandari S, Kalowski S, Collett P, Cooke BE, Kerr P, Newland R, Dowling J, Horvath J (2002) Karyomegalic nephropathy: an uncommon cause of progressive renal failure. Nephrol Dial Transplant 17:1914–1920CrossRef Bhandari S, Kalowski S, Collett P, Cooke BE, Kerr P, Newland R, Dowling J, Horvath J (2002) Karyomegalic nephropathy: an uncommon cause of progressive renal failure. Nephrol Dial Transplant 17:1914–1920CrossRef
4.
Zurück zum Zitat Colvin RB, Nikeleit V (2007) Polyomavirus nephropathy. In: Jenette JC, Olson JL, Schwartz MM, Silva FG (eds) Heptinstall’s pathology of the kidney. Lippincott Williams & Wilkins, Philadelphia, pp 1441–1447 Colvin RB, Nikeleit V (2007) Polyomavirus nephropathy. In: Jenette JC, Olson JL, Schwartz MM, Silva FG (eds) Heptinstall’s pathology of the kidney. Lippincott Williams & Wilkins, Philadelphia, pp 1441–1447
5.
Zurück zum Zitat Spoendlin M, Moch H, Brunner F, Brunner W, Burger HR, Kiss D, Wegmann W, Dalquen P, Oberholzer M, Thiel G, Mihatsch MJ (1995) Karyomegalic interstitial nephritis: further support for a distinct entity and evidence for a genetic defect. Am J Kidney Dis 25:242–252CrossRef Spoendlin M, Moch H, Brunner F, Brunner W, Burger HR, Kiss D, Wegmann W, Dalquen P, Oberholzer M, Thiel G, Mihatsch MJ (1995) Karyomegalic interstitial nephritis: further support for a distinct entity and evidence for a genetic defect. Am J Kidney Dis 25:242–252CrossRef
6.
Zurück zum Zitat Monga G, Banfi G, Salvadore M, Amatruda O, Bozzola C, Mazzucco G (2006) Karyomegalic interstitial nephritis: report of 3 new cases and review of the literature. Clin Nephrol 65:349–355CrossRef Monga G, Banfi G, Salvadore M, Amatruda O, Bozzola C, Mazzucco G (2006) Karyomegalic interstitial nephritis: report of 3 new cases and review of the literature. Clin Nephrol 65:349–355CrossRef
7.
Zurück zum Zitat Hassen W, Abid-Essafi S, Achour A, Guezzah N, Zakhama A, Ellouz F, Creppy EE, Bacha H (2004) Karyomegaly of tubular kidney cells in human chronic interstitial nephropathy in Tunisia: respective role of Ochratoxin A and possible genetic predisposition. Hum Exp Toxicol 23:339–346CrossRef Hassen W, Abid-Essafi S, Achour A, Guezzah N, Zakhama A, Ellouz F, Creppy EE, Bacha H (2004) Karyomegaly of tubular kidney cells in human chronic interstitial nephropathy in Tunisia: respective role of Ochratoxin A and possible genetic predisposition. Hum Exp Toxicol 23:339–346CrossRef
8.
Zurück zum Zitat Stohr W, Paulides M, Bielack S, Jurgens H, Treuner J, Rossi R, Langer T, Beck JD (2007) Ifosfamide-induced nephrotoxicity in 593 sarcoma patients: a report from the Late Effects Surveillance System. Pediatr Blood Cancer 48:447–452CrossRef Stohr W, Paulides M, Bielack S, Jurgens H, Treuner J, Rossi R, Langer T, Beck JD (2007) Ifosfamide-induced nephrotoxicity in 593 sarcoma patients: a report from the Late Effects Surveillance System. Pediatr Blood Cancer 48:447–452CrossRef
9.
Zurück zum Zitat Skinner R, Cotterill SJ, Stevens MC (2000) Risk factors for nephrotoxicity after ifosfamide treatment in children: a UKCCSG Late Effects Group study. United Kingdom Children’s Cancer Study Group. Br J Cancer 82:1636–1645CrossRef Skinner R, Cotterill SJ, Stevens MC (2000) Risk factors for nephrotoxicity after ifosfamide treatment in children: a UKCCSG Late Effects Group study. United Kingdom Children’s Cancer Study Group. Br J Cancer 82:1636–1645CrossRef
10.
Zurück zum Zitat Loebstein R, Atanackovic G, Bishai R, Wolpin J, Khattak S, Hashemi G, Gobrial M, Baruchel S, Ito S, Koren G (1999) Risk factors for long-term outcome of ifosfamide-induced nephrotoxicity in children. J Clin Pharmacol 39:454–461PubMed Loebstein R, Atanackovic G, Bishai R, Wolpin J, Khattak S, Hashemi G, Gobrial M, Baruchel S, Ito S, Koren G (1999) Risk factors for long-term outcome of ifosfamide-induced nephrotoxicity in children. J Clin Pharmacol 39:454–461PubMed
11.
Zurück zum Zitat Skinner R, Parry A, Price L, Cole M, Craft AW, Pearson AD (2010) Glomerular toxicity persists 10 years after ifosfamide treatment in childhood and is not predictable by age or dose. Pediatr Blood Cancer 54:983–989CrossRef Skinner R, Parry A, Price L, Cole M, Craft AW, Pearson AD (2010) Glomerular toxicity persists 10 years after ifosfamide treatment in childhood and is not predictable by age or dose. Pediatr Blood Cancer 54:983–989CrossRef
12.
Zurück zum Zitat Slavin RE, Millan JC, Mullins GM (1975) Pathology of high dose intermittent cyclophosphamide therapy. Hum Pathol 6:693–709CrossRef Slavin RE, Millan JC, Mullins GM (1975) Pathology of high dose intermittent cyclophosphamide therapy. Hum Pathol 6:693–709CrossRef
13.
Zurück zum Zitat Berns JS, Haghighat A, Staddon A, Cohen RM, Schmidt R, Fisher S, Rudnick MR, Tomaszewski JE (1995) Severe, irreversible renal failure after ifosfamide treatment. A clinicopathologic report of two patients. Cancer 76:497–500CrossRef Berns JS, Haghighat A, Staddon A, Cohen RM, Schmidt R, Fisher S, Rudnick MR, Tomaszewski JE (1995) Severe, irreversible renal failure after ifosfamide treatment. A clinicopathologic report of two patients. Cancer 76:497–500CrossRef
14.
Zurück zum Zitat Willemse PH, de Jong PE, Elema JD, Mulder NH (1989) Severe renal failure following high-dose ifosfamide and mesna. Cancer Chemother Pharmacol 23:329–330CrossRef Willemse PH, de Jong PE, Elema JD, Mulder NH (1989) Severe renal failure following high-dose ifosfamide and mesna. Cancer Chemother Pharmacol 23:329–330CrossRef
15.
Zurück zum Zitat Friedlaender MM, Haviv YS, Rosenmann E, Peylan-Ramu N (1998) End-stage renal interstitial fibrosis in an adult ten years after ifosfamide therapy. Am J Nephrol 18:131–133CrossRef Friedlaender MM, Haviv YS, Rosenmann E, Peylan-Ramu N (1998) End-stage renal interstitial fibrosis in an adult ten years after ifosfamide therapy. Am J Nephrol 18:131–133CrossRef
Metadaten
Titel
Karyomegalic-like nephropathy, Ewing’s sarcoma and ifosfamide therapy
verfasst von
Tom McCulloch
Andrew Prayle
Andy Lunn
Alan R. Watson
Publikationsdatum
01.07.2011
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 7/2011
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-1815-z

Weitere Artikel der Ausgabe 7/2011

Pediatric Nephrology 7/2011 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.