Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Kidney Res Clin Pract. 2013 Mar;32(1):39-42. doi: 10.1016/j.krcp.2012.09.008. Epub 2012 Oct 15.
Nephrotic syndrome (NS) rarely occurs after hematopoietic stem cell transplantation (HSCT) as a late manifestation of graft-versus-host disease (GVHD). Herein, we report a case of HSCT-associated membranous nephropathy in a female patient with aplastic anemia. The patient received an allogeneic HSCT from her human leukocyte antigen-identical brother following myeloablative conditioning chemotherapy. NS occurred 21 months after HSCT without any concurrent features of chronic GVHD. The patient was treated with prednisolone and cyclosporine after renal biopsy confirmed membranous nephropathy, and achieved complete remission. Our report contradicts previous assumptions that concomitant chronic GVHD is responsible for the development of NS, suggesting that NS can develop as a new, independent manifestation of GVHD.
肾病综合征(NS)作为移植物抗宿主病(GVHD)的一种迟发表现,在造血干细胞移植(HSCT)后很少发生。本文报道了一例再生障碍性贫血女性患者 HSCT 后并发膜性肾病。该患者接受了 HLA 相合同胞供者的异基因 HSCT,预处理方案为清髓性化疗。HSCT 后 21 个月出现 NS,无慢性 GVHD 的伴随特征。肾活检证实为膜性肾病后,患者接受泼尼松和环孢素治疗,获得完全缓解。本报告与既往认为同时存在慢性 GVHD 是 NS 发病原因的假设相矛盾,提示 NS 可作为 GVHD 的一种新的、独立的表现出现。