Renal Presentation in Pediatric XXXX : Report of 2 Cases.

@entity1 @entity8 @entity10486 @entity1133 @entity391 @entity3052 @entity1503 @entity1458 @entity1778 @entity810 @entity1011 @entity617 @entity414
@entity8 at time of diagnosis of @entity3052 is very unusual. We here in report 2 pediatric cases of @entity3052 who had their renal affection as the first presenting symptom with no evidences of blast cells in blood smear and none of classical presentation of @entity3052 . The first case is a 4-year-old @entity1 who presented with @entity10486 . Magnetic resonance imaging showed bilateral symmetrical homogenous enlarged kidneys suggestive of infiltration. @entity1503 ( @entity1503 ) revealed white blood count 11*10   /L, hemoglobin 8.7g/dL and platelet count 197*10   /L. Bone marrow aspiration was performed, and diagnosed precursor B-cell ALL was made. The @entity1 had an excellent response to modified CCG 1991 standard risk protocol of chemotherapy with sustained remission, but unfortunately relapsed 11 month after the end of therapy. The second @entity1 was 13-month old, presented with pallor, @entity391 , abdominal enlargement, and @entity1458 2 days before admission. Initial @entity1503 showed bicytopenia, elevated blood @entity1133 , @entity1011 , and serum @entity414 , while abdominal ultrasonography revealed @entity8 . Bone marrow examination was done and showed 92% blast of biphenotypic nature. So, @entity1778 with @entity8 and @entity810 was subsequently diagnosed. The @entity1 admitted to ICU and received supportive care and @entity617 . Renal function normalized and chemotherapy was started. The @entity1 achieved complete remission with marked @entity8 but, unfortunately she died from sepsis in consolidation phase of therapy. This case demonstrates an unusual early @entity8 in childhood @entity3052 . Renal involvement of @entity3052 should be considered in @entity1 presenting with unexplained @entity8 with or without @entity8 and bone marrow examination should be included in the workup.
