30 December 2025
: Case report 
Beyond CKD-Associated Pruritus: Paraneoplastic Itch Revealing CLL/SLL in ESRD: A Case Report
Unknown etiology, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology
Julia Kacperczyk
ADEF 1, Monika Dąbek ABCEF 1, Agnieszka Makówka CD 2, Michał Nowicki AE 2*
DOI: 10.12659/AJCR.949787
Am J Case Rep 2025; 26:e949787
Table 1 Timeline of key hematological findings and disease symptoms evolution. The table illustrates the chronological evolution of hematologic abnormalities in the patient, highlighting the persistence of leukopenia, the emergence of thrombocytopenia, and the discovery of generalized lymphadenopathy. Key diagnostic milestones, including imaging findings and bone marrow biopsy confirmation of CLL/SLL, are mapped against the patient’s clinical symptoms and systemic manifestations.
| Date | Key hematological findings & events |
|---|---|
| Peritoneal dialysis catheter insertion and initiation of RRT | |
| First documentation of leukopenia (low WBC count). No immediate diagnosis | |
| Leukopenia persists; our patient experiences delay in accessing hematologic consultation due to COVID-19 outbreak | |
| Kidney transplant pre-evaluation, including abdominal ultrasonography was performed, revealing peritoneal free fluid and hepatosplenomegaly. Concurrent leukopenia, thrombocytopenia, and subclavicular lymphadenopathy prompted hematological consultation | |
| Persistent leukopenia and emergence of thrombocytopenia, accompanied with subclavicular lymphadenopathy | |
| Bone marrow biopsy confirms CLL/SLL | |
| Blood tests reveal persistent leukopenia with neutropenia, and mild anemiaGastrointestinal symptoms appear; further imaging shows mediastinal widening and abdominal lymphadenopathy, indicating disease progression | |
| RRT – renal replacement therapy; CLL – chronic lymphocytic leukemia; SLL – small lymphocytic lymphoma. | |