The case history of a man with refractory chronic lymphocytic leukaemia who developed acute renal failure following treatment with fludarabine is presented. A renal biopsy specimen showed features of mesangiocapillary glomerulonephritis, a rare occurrence in chronic lymphocytic leukaemia. The rapid cytocidal action of fludarabine may result in the development of renal glomerular lesions when used to treat a well differentiated B cell malignancy.
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