局灶节段性肾小球硬化作为移植物抗宿主病的一种并发症。
Focal segmental glomerulosclerosis as a complication of graft-versus-host disease.
作者信息
Fofi Claudia, Barberi Simona, Stoppacciaro Antonella, Punzo Giorgio, Menè Paolo
机构信息
Renal Unit, Sant'Andrea University Hospital, University of Rome La Sapienza, Rome, Italy.
出版信息
Nat Rev Nephrol. 2009 Apr;5(4):236-40. doi: 10.1038/nrneph.2009.11.
BACKGROUND
A 54-year-old man with multiple myeloma underwent peripheral blood stem cell transplantation (PBSCT) with cells donated by his human leukocyte antigen (HLA)-identical sister. Eight months after PBSCT, the patient experienced chronic graft-versus-host disease with skin involvement (generalized erythema), mucosal ulceration, sicca syndrome, and elevated liver enzymes. Two years after PBSCT, the patient developed nephrotic syndrome with massive proteinuria, which required hospitalization.
INVESTIGATIONS
Physical examination, blood and urine analyses, liver function tests, 24 h urinary albumin excretion and renal biopsy.
DIAGNOSIS
Focal segmental glomerulosclerosis as a complication of graft-versus-host disease.
MANAGEMENT
Prednisone, ciclosporin and an angiotensin-converting-enzyme inhibitor.
背景
一名54岁的多发性骨髓瘤男性患者接受了由其人类白细胞抗原（HLA）匹配的姐姐捐献的外周血干细胞移植（PBSCT）。PBSCT八个月后，患者出现慢性移植物抗宿主病，累及皮肤（全身性红斑）、黏膜溃疡、干燥综合征及肝酶升高。PBSCT两年后，患者出现大量蛋白尿的肾病综合征，需住院治疗。
检查
体格检查、血液和尿液分析、肝功能检查、24小时尿白蛋白排泄量及肾活检。
诊断
局灶节段性肾小球硬化，为移植物抗宿主病的并发症。
治疗
泼尼松、环孢素及一种血管紧张素转换酶抑制剂。
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