Maintenance hemodialysis complicated with T-cell large granular lymphocytic leukemia and pure red cell aplasia: a case report
10.3760/cma.j.cn441217-20240923-00942
- VernacularTitle:维持性血液透析患者合并T细胞大颗粒淋巴细胞白血病伴纯红细胞再生障碍性贫血1例
- Author:
Yu WANG
1
;
Jingjing ZHANG
;
Qing ZHANG
;
Deguang WANG
Author Information
1. 安徽医科大学第二附属医院肾脏内科，合肥 230601
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Leukemia, large granular lymphocytic;
Hemoglobins;
Pure red cell aplasia
- From:
Chinese Journal of Nephrology
2025;41(10):764-767
- CountryChina
- Language:Chinese
-
Abstract:
T-cell large granular lymphocyte leukemia (T-LGLL) is a rare chronic lymphoproliferative disorder. This paper presents a T-LGLL patient who had been on maintenance hemodialysis for over 20 years. Three years prior, the patient developed erythropoietin hyporesponsiveness, with hemoglobin levels declining from 100 g/L to 49 g/L over eight months, accompanied by mild leukopenia and thrombocytopenia. Initial bone marrow biopsy and peripheral blood tests yielded inconclusive results. A 99mTc-labeled red blood cell spleen scintigraphy revealed evidence of hypersplenism, which prompted a splenectomy. Following surgery, leukopenia and thrombocytopenia resolved, but anemia persisted. Subsequently, lymphocyte counts increased, and reticulocyte progressively declined. Further investigations, including bone marrow biopsy, blood smear analysis, immunophenotyping, and T-cell receptor gene analysis, ultimately confirmed the diagnosis of T-LGLL with pure red cell aplasia. Treatment with cyclosporine resulted in a significant improvement in hemoglobin, reaching 117 g/L in 6 months. This case contributes to enhancing clinicians' awareness and understanding of this disease.
