THROMBOTIC MICROANGIOPATHY ASSOCIATED WITH ALPHA-INTERFERON THERAPY FOR CHRONIC MYELOCYTIC-LEUKEMIA

A 31-year-old man diagnosed as having chronic myelocytic leukemia (CML ) developed renal insufficiency with nephrotic-range proteinuria durin g alpha-interferon (IFN) therapy for CML. A renal biopsy specimen show ed remarkable thrombotic microangiopathic lesions resembling those of hemolytic-uremic syndrome. The patient had papules on both lower legs, and a cutaneous biopsy showed similar microangiopathic lesions in der mal and subcutaneous vessels. Although discontinuation of IFN and init iation of prednisolone therapy resulted in resolution of proteinuria, renal insufficiency persisted. These findings suggest that long-term I FN therapy can induce lat-eonset thrombotic microangiopathy in systemi c microvessels. (C) 1997 by the National Kidney Foundation, Inc.