Huskey Janna, Rivard Chris, Myint Han, Lucia Scott, Smith Maxwell, Shimada Michiko, Ishimoto Takuji, Araya Carlos, Garin Eduardo H, Johnson Richard J
Clin Nephrol. 2013 Dec;80(6):469-73. doi: 10.5414/CN107420.
Nephrotic syndrome is a rare complication of hematopoietic cell transplantation. It has been suggested that nephrotic syndrome may represent a limited form of graft-versus-host disease although the pathological link between these two entities remains unclear. In this paper, we report a case of a 61-year-old female who underwent nonmyeloablative allogenic stem cell transplantation for T-cell prolymphocytic leukemia and subsequently developed biopsy proven minimal change disease shortly after cessation of her immunosuppression therapy. Urinary CD80 was markedly elevated during active disease and disappeared following corticosteroid-induced remission. We hypothesize that alloreactive donor T cells target the kidney and induce podocyte expression of CD80 that results in proteinuria from limited 'graft versus host' disease.
肾病综合征是造血细胞移植的一种罕见并发症。有人提出，肾病综合征可能是移植物抗宿主病的一种局限形式，尽管这两种实体之间的病理联系仍不清楚。在本文中，我们报告了一例61岁女性病例，该患者因T细胞原淋巴细胞白血病接受了非清髓性异基因干细胞移植，在免疫抑制治疗停止后不久，经活检证实患上了微小病变病。在疾病活动期，尿CD80明显升高，在皮质类固醇诱导缓解后消失。我们推测，同种反应性供体T细胞靶向肾脏并诱导足细胞表达CD80，从而导致有限的“移植物抗宿主”病引起蛋白尿。
