Yabana M, Takagi N, Kihara M, Muto R, Tamura K, Maemoto S, Minamisawa M, Nakatani Y, Ishii M
Second Department of Internal Medicine, Yokohama City, University School of Medicine, Kanagawa, Japan.
Nihon Jinzo Gakkai Shi. 1997 May;39(4):414-20.
We reported a 27-year-old man who developed nephrotic syndrome 12 months after a bone marrow transplantation from his HLA-identical sister for chronic myelocytic leukemia. Anti-nuclear antibodies had been serially investigated after the bone marrow transplantation. They were detected in his serum 5 months before the appearance of proteinuria, but he tested negative at the onset of nephrotic syndrome. Histological analysis of the renal biopsy revealed subepithelial and subendothelial immune deposits in the glomerular basement membrane with increased mesangial matrix and cells. These findings suggested immune complex glomerulonephritis due to chronic graft-versus-host disease (GVHD) after bone marrow transplantation. In murine experimental chronic GVHD, anti-nuclear antibodies, which generate immune complexes that deposit or form in the kidney have been detected.
我们报告了一名27岁男性，他在接受来自 HLA 相同的姐姐的骨髓移植以治疗慢性粒细胞白血病12个月后出现了肾病综合征。骨髓移植后对其抗核抗体进行了连续检测。在蛋白尿出现前5个月，其血清中检测到了抗核抗体，但在肾病综合征发病时检测为阴性。肾脏活检的组织学分析显示，肾小球基底膜有上皮下和内皮下免疫沉积物，伴有系膜基质和细胞增多。这些发现提示骨髓移植后慢性移植物抗宿主病（GVHD）导致免疫复合物性肾小球肾炎。在小鼠实验性慢性GVHD中，已检测到可产生在肾脏中沉积或形成的免疫复合物的抗核抗体。
