[Lymphocytic leukopenia in two patients affected by polycystic kidney disease waiting for renal transplantation].

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, responsible for 10% of patients on renal replacement therapy. The disease is well known to be associated with many extrarenal manifestations. Leukopenia may also be present, even if it is not commonly identified as a typical extrarenal manifestation. Herein we describe two case reports of ADPKD patients with leukopenia. The first case is about a 47-year-old patient affected by ADPKD, regularly treated with peritoneal dialysis, who showed a progressive reduction of white blood cell count, mostly of lymphocytes. Lymphocytic leukopenia was so severe that, when he was called for transplantation from a deceased donor, he was considered temporarily not eligible. We then describe a second ADPKD patient regularly treated with peritoneal dialysis, who had stable lymphopenia for years. Six years after starting PD, it was necessary to perform bone marrow aspirate to investigate the simultaneous presence of hypogammaglobulinemia together with M-protein and to exclude monoclonal gammopathy. All the exams performed did not show any significant results, the patients were re-included in the waiting list and one of them was transplanted. Given our experience and what is reported in the literature, there seems to be enough evidence to consider leukopenia as an extrarenal manifestation of ADPKD. However, the clinical significance of leukopenia in ADPKD patients is not known. It could be interesting to investigate the leucocytes' function and if ADPKD patients with leukopenia are more susceptible to infection, or not. Moreover, it would be very useful to analyze the relationship between such manifestation and genotype/phenotype.

• Authors: Elisa Costa, Anna Giuliani, Valentina Corradi, Carlotta Caprara, Matteo Rigato, Sabrina Milan Manani, Ilaria Tantillo, Claudio Ronco, Fiorella Gastaldon, Monica Zanella
• Journal: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia (G Ital Nefrol) Vol. 39 Issue 2 (Apr 21 2022) ISSN: 1724-5990 [Electronic] Italy
• PMID: 35470994 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

Topics

• Female
• Humans
• Kidney Transplantation
• Leukopenia (complications)
• Male
• Peritoneal Dialysis
• Polycystic Kidney Diseases (complications)
• Polycystic Kidney, Autosomal Dominant (complications, surgery)