Renal cortical necrosis secondary to thrombotic microangiopathy in the context of acute promyelocytic leukaemia blast crisis

37 year old patient was admitted in charge of Hematology, moved from the emergency department of ORL where he had gone for tonsillitis, there is shown and enter anaemia and leucopoenia with agranulocytosis in study. One day later the patient blast crisis and was diagnosed with acute myeloid acute leukaemia. In that situation the patient blast crisis begins a sharp low back pain box with oliguria and impaired renal function, followed by anaemia in the context of a compatible haemolysis thrombotic microangiopathy (haemolytic uremic syndrome), so we consulted. Treatment was initiated with plasmapheresis and haemodialysis next day. (There is a total of 12 sessions of plasmapheresis, disappearing data haemolysis). Five days later presented respiratory failure by passing to UCI, where plasmapheresis continuous haemodialysis. The patient is kept in anuria since then, requiring dialysis, with no sign of renal recovery. Once platelets normalized with hematologic chemotherapy, percutaneous renal biopsy was performed to confirm the diagnosis of cortical necrosis. Finally the program is included in patient kidney function replacement by haemodialysis.