Membranous nephropathy after allogeneic hematopoietic stem cell transplantation in a patient with aplastic anemia: a case report.
Nephrotic syndrome has been described as one of the clinical forms of chronic graft-versus-host disease (cGVHD), but a limited number of cases have been described. We experienced a young female patient with nephrotic syndrome developed 22 months after allogeneic hematopoietic stem cell transplantation (HSCT) for severe aplastic anemia. She had been well after successful management for gut-limited cGVHD until she developed a clinical nephrotic syndrome with hypoalbuminemia of 2.0 g/dL and 24-hr urine protein of 6.88 g/dL. On physical examination and laboratory findings, there was no other evidence of cGVHD. Clinical and renal biopsy findings were consistent with cGVHD-related membranous nephropathy, and immunosuppressive agents with cyclosporine and prednisone were prescribed. After 3 month of treatment, the proteinuria decreased to normal range; and the patient from nephrotic syndrome nearly recovered. We recommend cGVHD-related glomerulonephritis should be considered in all patients with hypoalbuminemia following allogeneic HSCT, even if there is no other evidence of clinical GVHD.
Kim
Kee Won
KW
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Yoon
Chong Hyeon
CH
Kay
Chul Seung
CS
Kim
Hee Jung
HJ
Suh
Kwang-Sun
KS
Kim
Suk Young
SY
Park
Suk Young
SY
D000328:Adult; D000741:Anemia, Aplastic / Q000503:physiopathology / Q000628:therapy; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000209:etiology* / Q000473:pathology; D006086:Graft vs Host Disease / Q000503:physiopathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology