Trombotic microangiopathy and b-lymphoblastic leukaemia: rare combination or related condition?

THE AIM: to show a rare combination and possible pathogenetic relationship of thrombotic microangiopathy and acute lymphoblastic leukemia in a child. PATIENTS AND METHODS. The analysis of the history and clinical laboratory data of the patient. RESULTS. 9 months after the debut of thrombotic microangiopathy with damage to the central nervous system, acute lymphoblastic leukemia was diagnosed in the form of transient attacks of cerebral circulation and kidneys with the development of the nephrotic syndrome. The literature data show that in rare cases secondary thrombotic microangiopathy precedes the unfolded picture of hematologic disease, pathogenetic therapy of leukemia leads to remission of thrombotic microangiopathy. The article discusses the possible relationship between the two states in a child. CONCLUSION. Although the relationship of thrombotic microangiopathy and acute leukemia in the present case is not obvious, the authors believe that it is necessary to remember about the possibility of developing secondary microangiopathy on the background of oncohematological diseases, and in doubtful cases to conduct a study of the bone marrow in patients.