Yang Jing, Zhang Liyin, Sha Wengang, Liu Shaojun, Shen Lei
Department of Nephrology, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215000, Jiangsu, China.
Renal Division, Huashan Hospital, School of Medicine, Shanghai Fudan University, Shanghai, China.
J Nephrol. 2024 Aug 4. doi: 10.1007/s40620-024-01988-7.
Chronic graft-versus-host disease (GvHD) is the leading cause of late death in allogenic hematopoietic stem cell transplantation recipients, of which the kidney is a potential target. In this article, we report an extremely rare case of chronic GvHD, characterized by immune complex-mediated diffuse proliferative glomerulonephritis and various autoantibodies detected in the serum; it is the first case of lupus-like chronic GvHD reported to date. The patient responded well to intensive immunosuppressive therapy and reached complete remission. Mycophenolate mofetil was more effective than tacrolimus in this case, suggesting that treatment of kidney diseases associated with chronic GvHD should be based on pathogenesis and pathological patterns.
慢性移植物抗宿主病（GvHD）是异基因造血干细胞移植受者晚期死亡的主要原因，其中肾脏是潜在的靶器官。在本文中，我们报告了一例极为罕见的慢性GvHD病例，其特征为免疫复合物介导的弥漫性增殖性肾小球肾炎以及血清中检测到多种自身抗体；这是迄今为止报道的首例狼疮样慢性GvHD病例。该患者对强化免疫抑制治疗反应良好并实现了完全缓解。在本病例中，霉酚酸酯比他克莫司更有效，这表明与慢性GvHD相关的肾脏疾病的治疗应基于发病机制和病理模式。
