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已发表论文
急性早幼粒细胞白血病罕见病例报告：长期急性肾损伤与对称性周围神经节坏死
Authors Kong YK, Shu H, Zhang WJ, Wu CY
Received 25 April 2025
Accepted for publication 9 September 2025
Published 25 September 2025 Volume 2025:18 Pages 13313—13318
DOI https://doi.org/10.2147/JIR.S533309
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Wenjian Li
Yu-Ke Kong,1,* Hong Shu,1,* Wen-Jun Zhang,1 Chong-Yang Wu2
1Department of Nephrology, Lanzhou University Second Hospital, Lanzhou, Gansu, People’s Republic of China; 2Department of Hematology, Lanzhou University Second Hospital, Lanzhou, Gansu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hong Shu, Department of Nephrology, Lanzhou University Second Hospital, No.82, Cuiyingmen, Chengguan District, Tel +8613919194565, Email greatdreamsh@163.com
Abstract: Acute kidney injury (AKI) is a serious complication of acute promyelocytic leukemia (APL). However, symmetric peripheral gangrene (SPG) and AKI have rarely been reported in this disease. Here we present the case of a patient who developed life-threatening APL complicated by AKI and SPG. Laboratory investigations revealed disseminated intravascular coagulation (DIC), respiratory failure, renal insufficiency, hepatic insufficiency, cardiac failure, and infection with multiple pathogens, including: novel coronavirus disease (COVID-19), candida monda, saccharomyces capitis, aspergillus fumigatus, candida lusitaniae, aspergillus flavus. One month later, the patient was off the ventilator, but his renal function needed hemodialysis. He also developed SPG, particularly the fingers of the hands and feet. After two months, the patient was discharged from hospital with normal liver and heart function. Four months after discharge, the patient’s APL was on the mend, but some of the gangrenous sites had undergone autoamputation. Therefore, AKI and SPG are complex clinical complications in APL that pose significant challenges to clinicians. In addition to coagulopathy, the presence of COVID-19 and DIC worsened the clinical outcomes. At the same time, we extensively reviewed the literature to provide a comprehensive analysis of the pathogenesis and management strategies of these complications.
Keywords: acute kidney injury, acute promyelocytic leukemia, symmetrical peripheral gangrene, disseminated intravascular coagulation, case report
1Department of Nephrology, Lanzhou University Second Hospital, Lanzhou, Gansu, People’s Republic of China; 2Department of Hematology, Lanzhou University Second Hospital, Lanzhou, Gansu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hong Shu, Department of Nephrology, Lanzhou University Second Hospital, No.82, Cuiyingmen, Chengguan District, Tel +8613919194565, Email greatdreamsh@163.com
Abstract: Acute kidney injury (AKI) is a serious complication of acute promyelocytic leukemia (APL). However, symmetric peripheral gangrene (SPG) and AKI have rarely been reported in this disease. Here we present the case of a patient who developed life-threatening APL complicated by AKI and SPG. Laboratory investigations revealed disseminated intravascular coagulation (DIC), respiratory failure, renal insufficiency, hepatic insufficiency, cardiac failure, and infection with multiple pathogens, including: novel coronavirus disease (COVID-19), candida monda, saccharomyces capitis, aspergillus fumigatus, candida lusitaniae, aspergillus flavus. One month later, the patient was off the ventilator, but his renal function needed hemodialysis. He also developed SPG, particularly the fingers of the hands and feet. After two months, the patient was discharged from hospital with normal liver and heart function. Four months after discharge, the patient’s APL was on the mend, but some of the gangrenous sites had undergone autoamputation. Therefore, AKI and SPG are complex clinical complications in APL that pose significant challenges to clinicians. In addition to coagulopathy, the presence of COVID-19 and DIC worsened the clinical outcomes. At the same time, we extensively reviewed the literature to provide a comprehensive analysis of the pathogenesis and management strategies of these complications.
Keywords: acute kidney injury, acute promyelocytic leukemia, symmetrical peripheral gangrene, disseminated intravascular coagulation, case report